EFS Card Transactions Fuel and Gas - EFS Card Transactions NOTE: This is for ALL purchases made using the EFS CardDriver Name* First Last Branch Location:*CarrollCedar RapidsDes MoinesDubuqueKansas CityLas VegasLincolnOrlandoPhoenixRockfordSaint LouisSioux FallsTransaction Date* MM slash DD slash YYYY Product Purchased* Diesel Fuel Gasoline DEF Parking (Emergency Use Only) Other Select payment method or location* EFS Dubuque Airport KC Bulk Fuel River City - Las Vegas Rockford Bulk Fuel Roxana - Fast Stop Blue Beacon Charge Account - PHX Section BreakVehicle Number* Enter the 3-5 digit vehicle numberOdometer Reading* Station Name* State* State / Province / Region Price Per Gallon*Please enter a number from 0 to 25.Gallons Purchased*Total AmountTotal Amount*Include picture of receipt* Drop files here or Select files Max. file size: 128 MB, Max. files: 3. Enter Vehicle Number or Charter Number:* Enter a brief description of what was purchased*