Withdraw Funds

Client

Name of Client :

Client ID :

Personal Number :

EMAIL :

Amount :

Country :

City :

Adress :

Postcode :


Receiving Bank

SwiftCode (ABA, if used intermediary) :

Bank Name :

Bank Adress :

Receiving BANK :

Number of Bank account :

Intermediary Bank

SwiftCode :

Bank Name :

Receiving BANK :

Bank account number :

Payment method :
Bank
Credit Card

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