Need a South Holland charging card?

Please complete the form below without obligation.

Please note: The SGZH charging card can only be requested by customers who live or work in one of the affiliated municipalities. You will receive one card per request because it is linked to each account. If you need more than one card, please submit multiple requests.

I am a former Shell Recharge customer

Form.

Please note: Are you a former Shell Recharge customer and would you like to request a 50five charging trickle? Then use the other form.

Onderwerp *

Source *

Partner entity

Laadpas Zuid-Holland

Legal entity 50five *

50five B.v.

Job type *

Charge Card

Salutation *

Please select from the following: Sir, Madam.

Your first and last name *

Email adress *

Phone number *

Street name and house number *

Addition

Zip code *

City *

In which municipality do you live or work? *

If the municipality where you live or work is not listed here, you are not eligible for the South Holland charging card. The SGZH charging card can only be requested by customers who live or work in one of the participating municipalities.

Company name

If it concerns a business application.

VAT number

If it concerns a business application.

Do you already have a 50five or South Holland charging card or charging trickle?

Yes

Comments

Declaration of correctness of entered data *

I hereby declare that I have completed this form truthfully.

Data processing *

JYes, I agree to the use of personal data and its sharing with the billing party, Threeforce BV in accordance with the 50five privacy policy and the terms and conditions for the 50five charging card and charging trickle.

Send

Once requested, your charging card will be sent within 10 working days.