Withdraw Request - eCash

After you complete this form, click Print-friendly for a printable version, sign it, and return it to GCI via email along with a copy of a valid identification.

This form may be scanned and emailed to [email protected].

GCI does not charge for sending payments, however transfer fees are applied by our payment system provider. Forms submitted with missing information are subject to delay.

Required fields are indicated with an asterisk (*).

Your GCI Account Information
Last Name*: Account Currency*:
First Name*: Withdrawal Amount*:
Address 1*: Address 2:
City*: State/Province*:
Country*: Your E-mail*:
GCI Account Number*: Contact telephone number*:

eCash Information
eCash type*:

Additional Information
Will you be closing your account*?
Any comments on our service?

Please complete all required fields