*50¢ off per gallon in Fuel Statement Credits for the first 90 days the account is open. 50¢ off applies to each billing cycle you purchase 45 gallons or more. Savings provided as a Fuel Statement Credit on up to 110 gallons in any qualifying billing cycle. Maximum of $99.00 in Fuel Statement Credits may be earned in a 12-month period beginning on your December billing cycle. Subject to credit approval.

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Your Information

All fields are required unless stated otherwise.

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First Name

M.I. Optional

Last Name

Suffix Optional

Street Address

Apt # Optional

Zip Code

City & State

Housing

Primary Phone

Type

Alternate Phone Optional

Type

Email Address

Confirm Email Address

Date of Birth

Last 4 digits of SSN/ITIN

SSN/ITIN

Annual Net Income

$ .00

Service Station ID

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City & State

Zip Code

Service Station ID

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Service Station ID

Select the station you visit most often. Optional

Retrieving locations

Employee Identifier (3-4 characters) Optional

Associate Name Optional

Optional

Joint Applicant

Joint Applicant Information - An additional card will be issued to the person indicated below. The applicant (and joint applicant, if any) will be liable for all transactions made on the account including those made by any authorized user.

JOINT APPLICANT: you agree that we may send notices to you and/or at the applicant’s address, regardless of whether you live at that address. Your providing your name below represents your signature to the application and agreement to all of the terms in this application.

First Name

M.I. Optional

Last Name

Suffix Optional

Street Address

Apt # Optional

Zip Code

City & State

Optional

Primary Phone

Type

Alternate Phone Optional

Type

Email Address

Confirm Email Address

SSN/ITIN

Date of Birth

Annual Net Income

$ .00

Optional

Sharing your location when prompted may allow you to be considered for the best possible credit limit, if approved.

By applying you agree that, if approved, Synchrony Bank may provide you with a Phillips 66® Aviation Personal Credit Card.

Your Information

Electronic Billing Statement Delivery

Service Station ID

Service Station ID

Service Station ID

Joint Applicant

Electronic Billing Statement Delivery