Comdata Fuel Card Application
Carrier Legal Name
Client FEIN
(Federal Employer ID Number)
Address (PO BOX NOT ACCEPTED)
City
State
Zip
Principle Owner Name
Business Phone
US DOT #
MC #
# of PU’s
Owners Date of Birth
ICD Website Access
This form is used to set up access to the Comdata website and to speak with customer service. You will
set up code words for all Comdata website users. Cardholders will use this code word to verify user’s
identity when speaking with Comdata Customer Service. Each user must have a different email, phone
number, and code word.
If you would like to setup additional secondary logins, please request additional form from OTR Capital.
ONCE YOUR CARDS ARE PROCESSED, EACH USER WILL RECEIVE AN EMAIL FROM
iConnectdata@comdata.com WITH YOUR TEMPORARY USER NAME AND PASSWORD. PLEASE LOG IN AS
SOON AS YOU RECEIVE THIS EMAIL.
PRIMARY LOGIN
Full Name
Email
Desired code word
Card Set-Up
In this section you will set up your Comdata card spending profiles. You will also assign Employee ID
Numbers (similar to a PIN number), as these will be needed when making purchases with the Comdata
cards.
Standard Profiles
Please select a profile from below for your secondary card(s) needs OR create a custom profile below.
Spending Profiles to choose from for Secondary Cards:
1 - Unlimited Fuel & Purchases + Unlimited Cash & Comcheks (For Primary Card Only)
2 - $500/Fuel & Purchases + Cash & Comcheks by request only
3 - $1000/Fuel & Purchases + $100 in cash per day
4 - $1500/Fuel & Purchases + $500 in cash per day
5 - $2000/Fuel & Purchases + $1000 in cash per day
6 - $3000/Fuel & Purchases + $1500 in cash per day
PRIMARY CARD HOLDER
This card will have unlimited access to funds on the account
Full Name
Employee ID (PIN ) Number (4 digits)
SECONDARY CARD HOLDER
(OPTIONAL)
Full Name
Employee ID (PIN ) Number (4 digits)
Spending Profile (Choose from above):
SECONDARY CARD HOLDER
(OPTIONAL)
Full Name
Employee ID (PIN ) Number (4 digits)
Spending Profile (Choose from above):
SECONDARY CARD HOLDER
(OPTIONAL)
Full Name
Employee ID (PIN ) Number (4 digits)
Spending Profile (Choose from above):
*Please reprint this page if you want more drivers to have access to the Comdata website*
Initial Comchek Order
When applying for Comdata fuel cards, you have the option to receive a set of blank Comcheks. The
maximum order is 50 Comcheks at a time. You have the ability to create Comchek drafts using Comdata’s
smartphone app for iPhone and Android devices, or by calling Comdata directly. These will be shipped
separately from your cards. To order, please visit www.ordercomchecks.com and use code OT058.
Direct Deposit
With your Comdata Card, you will have the ability to transfer funds from your Comdata account to your
personal or business bank account. This does not give you the ability to add funds to the cards from your
personal bank account.
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