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FUEL CARD REQUEST
Questions?
Call:
402-656-3615
Please complete the form below
*Required Fields
*Account Last Name:
*Account First Name:
*Farmers Cooperative Account Number:
Farmers Cooperative Fuel Card Number (please enter if known):
*What type of fuel card is needed?:
New card
Duplicate card (same pin # and card # as current card)
*Do you wish to deactivate a current card?:
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