Retirer des fonds - Virement Bancaire

Wire Transfer Request Form

Demande de Retrait - Transfert Bancaire

Informations de votre Compte

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.

Information Banque Bénéficiaire

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.

Information de Compte Bénéficiaire

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

Information Supplémentaire

Please select an option.
Veuillez remplir tous les champs obligatoires