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By submitting this application, I hereby warrant that the above information is true and correct and request that an account to be opened and a Caltex Joyfuel Card be issued to me. I acknowledge that I am providing the #additional information above entirely voluntarily and I understand that failure to provide such information would not affect my Caltex Joyfuel Card application or would not result in Chevron not being able to supply the services and products offer by Caltex Joyfuel Card. I acknowledge that Chevron may refuse to accept this application without giving me any prior notice or reason therefor.

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