Wire Transfer Request Form

Solicitação de retirada - Transferência bancária

Informações da sua conta GCI

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.

Informações do Banco Beneficiário

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.

Informações da conta do beneficiário

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

Informações adicionais

Please select an option.
Por favor, preencha todos os campos obrigatórios