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:
*
2020-01-18
2020-01-17
2020-01-16
2020-01-15
2020-01-14
2020-01-13
2020-01-12
2020-01-11
2020-01-10
2020-01-09
2020-01-08
2020-01-07
2020-01-06
2020-01-05
2020-01-04
2020-01-03
2020-01-02
2020-01-01
2019-12-31
2019-12-30
2019-12-29
2019-12-28
2019-12-27
2019-12-26
2019-12-25
2019-12-24
2019-12-23
2019-12-22
2019-12-21
2019-12-20
2019-12-19
Litres dispensed:
*
I accept the Terms and conditions:
*
Submit