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BANK INFORMATION

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⚠️ Please ensure accuracy when providing these details as incorrect information could affect delivery of your payout/refund or incur additional charges for a failed attempt.

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What is the reason for providing your bank information? ^*

Refund

Referral Payout

Other

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Your Contact Info ^*

First Name ^*

Last Name ^*

Email ^*

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Bank Name ^*

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Bank Address ^*

Address ^*

Address line 2

City ^*

State / Province

Zip / Postal Code

Country ^*

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Exact Name On Account ^*

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Personal Address ^*

This must be the exact address under your name with the bank.

Address ^*

Address line 2

City ^*

State / Province

Zip / Postal Code

Country ^*

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In the following slides, please provide what is applicable to your region.

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Routing Number

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Account Number

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SWIFT/BIC Number (if necessary)

🌍 For international (non-USA) banks.

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IBAN Number (if necessary)

🌍 For international (non-USA) banks.

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Government-Issued Photo ID ^*

We use this to verify the payout recipient.

You can drag & drop or paste as well

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