claim submitted successfully
\nreference: {{reference}}
\nWe were unable to save the vehicle image submitted. Please visit the evidence manager to upload the vehicle image.
\nWe were unable to save the receipt image submitted. Please visit the evidence manager to upload the receipt image.
\nNo Means of Payment Form
\n\nIf you are uploading a PDF, only the first page of that PDF will be submitted with the claim. Please make sure that the till receipt is visible below when submitting!
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\nPlease be advised that only the 1st page of the PDF will be kept!
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\nPlease be advised that only the 1st page of the PDF will be kept!
\n \nIMPORTANT: Any additional information which may be important when chasing the stolen fuel should be entered into the comments field below. For example, if the driver filled a cannister please mention that below.
\nVARS Technology - No Means of Payment Agreement
\n\nWarning: This is a legally binding agreement. Accept it only if you understand its terms and wish to be bound by them.
\nI agree to pay the above sum within four (4) days of today's date. Payment should be made online at varsanpr.co.uk (There is a £5.00 administration charge).
\nIn the event of non-payment, I understand that I will be liable for the amount stated above, together with all the costs of enforcing this agreement against me.
\nI declare that all information given by me on this form is true to the best of my knowledge and belief.
\nThis agreement provides that in the event of non-payment of the full amount within four (4) days of today’s date, the £5.00 administration charge will increase to\n £15 for a further 10 days. If the full payment is not received during this entire period then it will be deemed as fuel theft and treated as a drive off incident\n where you will become liable for a £60 charge and may be pursued through debt collection agencies and/or court proceedings.
\nThis agreement provides for the use of my personal data in certain circumstances, including sensitive personal data in accordance with the Data Protection Act.
\nI hereby declare that I have no outstanding 'No Means of Payment' events at this or any other fuel retailer and if this is found to be false then my actions in completing and signing this\n form may be considered as dishonest and therefore fraudulent, criminal and liable for prosecution.
\n\n \nSubmit the No Means of Payment form using the button below. You will be able to upload the till receipt and evidence via the claim manager.
\n{{submitStatus}}
\nPlease fix the following issues before attempting to submit:
\n- \n
- {{e}} \n