Wire Transfer Request Form

Withdraw Request - Wire Transfer

Your GCI Account Information

Personal Information
Please provide your first name.
Please provide your last name.
Please provide a valid email address.
Please provide your contact telephone number.
Account Details
Please provide your GCI account number.
Please select your account currency.
Please provide a valid withdrawal amount.
Address Information
Please provide your address.
Please provide your city.
Please select your country.

Beneficiary Bank Information

Please provide the bank name.
Please provide the bank address.
Please provide the bank city.
Please select the bank country.
Please provide the Swift code.

Beneficiary Account Information

Please provide the bank account number.
Please select the account type.
Please provide the account name.

Additional Information

Please select an option.
Please complete all required fields