Pioneer Dynamic Limited 鋒生有限公司



	Mr. 先生 Ms. 小姐 Mrs. 女士 If you wish to receive the lastest promotion through email, please fill in the e-mail address. 如欲透過電郵接收最新優惠推廣，請填寫電郵地址。



	If you wish to check your transaction record through our website, please fill in the e-mail address. 如欲透過網上查詢交易紀錄，請填寫電郵地址。

Petrol 電油

Diesel 油渣

Petrol 電油

Diesel 油渣



	I hereby authorize Pioneer Dynamic Ltd. ("PDL") to charge my below credit card account for fuel card service provided by PDL to the applicant of this Esso Fleet Card Application Form. This authorization shall have effect until further notice. This authorization shall have effect after the expiry date of the credit card stated below. 本人現授權鋒生有限公司，就按其為此埃索車隊咭申請表的申請人所提供的油咭服務，於本人下述之信用咭脹戶內扣取有關費用。本授權書將繼續生效直至另行通知為止。本授權書於下列信用咭有效期後仍然生效。月份 MONTH 年份 YEAR



	Taxi 的士 Mini Bus 小巴 Van 輕型貨車 Tractor or Truck 拖頭/貨車 Private Car 私家車 Motorcycle 電單車 Others 其他 Self-owned 車主 Others 其他



	閣下可以在此上載有關文件 Please upload your vehicle registration documents. 請上傳您的牌簿或行車証影印本圖像檔 Please upload your HKID documents. 請上傳您的身份証影印本圖像檔註 : 如果閣下因沒有掃瞄器而無法掃瞄上載，請剔以下選項，以及把車輛號碼寫在有關文件上，然後傳真到2191 9121。本人以傳真方式提交有關文件



	閣下可以在此上載有關文件 Please upload your vehicle registration documents. 請上傳商業登記證影印本圖像檔 Please upload sole proprietor or partner HKID documents. 請上傳東主/合夥人的身份証影印本圖像檔 Please upload your vehicle registration documents. 請上傳牌簿或行車証影印本圖像檔註 : 如果閣下因沒有掃瞄器而無法掃瞄上載，請剔以下選項，以及把車輛號碼寫在有關文件上，然後傳真到2191 9121。本人以傳真方式提交有關文件

I/We declare that all information on this form is true and complete. I/We authorize Pioneer Dynamic Limited (”PDL”) to confirm it from whatever source you choose. I/We understand that this application form and all submitted documents remain the properties of PDL. If my/our application is accepted by PDL. I/We agree to be bound by the terms of the PDL Credit Agreement as amended from time to time by PDL. I/We ensure the Vehicle Registration No. being listed belong(s) to my/our proprietor’s/partners’/employee’s/relatives’ and I/we shall be responsible for all transactions and agree to settle the outstanding balance of this(these) fuel card(s).
本人/本公司證實以上各項資料均屬詳實。本人/本公司同意鋒生有限公司（「鋒生」）向任何有關方面查詢。不論申請批淮與否，本人／本公司明白此申請表及所有遞交的文件均不獲退回。如申請獲鋒生接納，本人／本公司願意遵守鋒生記脹合約內之條款，並接納鋒生可隨時修改此等條款。本人／本公司確認上列車牌號碼之車輛乃本人／本公司股東／合伙人／僱員／親屬所擁有，並願意承擔以上各車輛使用燃油咭之記賬金額。

I/We hereby declare that I/We read, acknowledge and agree the terms and conditions of the declaration of Esso fleet card. PDL and any person set out in application form to utilize such data and information for direct marketing purpose, please tick here.
本人/ 本公司謹此聲明，本人/ 本公司已細讀、明白及同意有關鋒生埃索車隊咭的聲明條款。本人/ 本公司同意鋒生及申請表所述人士於直接促銷使用該等個人資料，請以✓表示。

I declare that all information on this form is true and complete. I authorize you to confirm from whatever source you choose. I understand that this application form remains the property of Pioneer Dynamic Limited (”Pioneer”). If my application is accepted by Pioneer, I agree to be bound by the terms of the Discount Card Agreement as amended from time to time by Pioneer.
本人證實以上各項資料均屬詳實。本人同意貴公司向任何有關方面查詢。本人同時亦明白此申請乃鋒生有限公司之所物，不論申請批准與否。均可由貴公司保管。如申請獲鋒生有限公司接納，本人願意遵守折扣咭合約內之條款，並接納此等條款鋒生有限公司可隨時作出修改。

I hereby declare that I read, acknowledge and agree the terms and conditions of the declaration of Esso fleet card. PDL and any person set out in application form to utilize such data and information for direct marketing purpose, please tick here.
本人謹此聲明，本人已細讀、明白及同意有關鋒生埃索車隊咭的聲明條款。本人同意鋒生及申請表所述人士於直接促銷使用該等個人資料，請以✓表示。