Wire Transfer Request Form

Solicitud de retiro de fondos - Transferencia bancaria

Información sobre su cuenta 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.

Datos bancarios del beneficiario

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.

Datos de la cuenta del beneficiario

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

Información Adicional

Please select an option.
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