Customer Information

Full Name: Email Address: Phone Number: Address: City : State/Province: Zip/Postal Code:

Customer Information

Service Type: (Please select one) —Please choose an option—Trade ExchangeWTE MembershipCountertrade MembershipDigital Bank SetupDigital Currency ExchangePrivate CurrencyPlatformOthers Invoice Number: Invoice Date: Payment Date: Total Amount Paid: Account Paid To: Payment Method:

Reason for Refund

(Please select the reason that best describes your request) —Please choose an option—Service not delivered at allFunctionality issues with the serviceService did not meet specificationsDelayed implementationDuplicate order/paymentChanged mind Other (Please specify):

Refund Details

Refund Amount Requested: Date of Refund Request: Preferred Refund Method:

Additional Comments or Attachments

(Please provide any relevant details, documentation, or files to support your request) Enter your statement here

Bank Account Details for Refund

ACCOUNT DETAILS:

ACCOUNT NAME: ACCOUNT NUMBER: SWIFT CODE: BIC CODE: ADDRESS: ZIP CODE: COUNTRY: EMAIL ADDRESS: PURPOSE OF PAYMENT: AMOUNT TO TRANSFER: PURPOSE OF PAYMENT

BANK DETAILS:

BANK NAME: COUNTRY CODE: BANK CODE: BRANCH CODE: KEY: SWIFT CODE: BIC CODE: BANK ADDRESS: CITY: ZIP CODE: BANK PHONE COUNTRY

Terms & Conditions

● By submitting this form, you acknowledge that you have read and agree to the refund policy.

● Refunds are processed within 90 business days after approval.

● Certain services may be subject to fees or deductions as stated in the refund policy.

Signature

I certify that the information provided is accurate and request a refund based on the above details.

Name Date