Loading..
Submit Claim
Terms and Conditions
Info:
Upload Till Slip:
Browse...
Browse...
0%
Cancel
Common error text is displayed here
Dis-Chem Benefit Card Number:
*
Name:
*
Surname:
*
Email:
*
Service Station:
*
NA - ATOK
NA - B1 CITY
NA - Barry's Motors
NA - Black Rock Service Station
N051 - Buffelskloof Service Station
NA - Butha Buthe Motors
NA - Cross Roads Garage
NA - DUMELA- PECR
NA - Eastgate Service Station
NA - Echo Service Station
Fuel Type:
*
Excellium Diesel Plus
Excellium Diesel Premium Plus
Excellium Premium 93
Excellium Unleaded 93
Excellium Unleaded 95
Transaction Number (Stan):
*
Date of Transaction:
*
2020-04-05
2020-04-04
2020-04-03
2020-04-02
2020-04-01
2020-03-31
2020-03-30
2020-03-29
2020-03-28
2020-03-27
2020-03-26
2020-03-25
2020-03-24
2020-03-23
2020-03-22
2020-03-21
2020-03-20
2020-03-19
2020-03-18
2020-03-17
2020-03-16
2020-03-15
2020-03-14
2020-03-13
2020-03-12
2020-03-11
2020-03-10
2020-03-09
2020-03-08
2020-03-07
2020-03-06
Litres dispensed:
*
I accept the Terms and conditions:
*
Submit