Withdrawal Application - Credit Card / PayPal Form

After you complete this form, click Print-friendly for a printable version, then print it and return it signed to GCI Financial. This form may be scanned and emailed to payments@gcitrading.com or faxed to any of our fax numbers available at http://www.gcitrading.com/fax.htm. GCI does not charge for sending payments, however transfer fees are applied by our payment system provider. This request will be processed within two business days of receipt of this form. Forms submitted with missing information are subject to delay.

Your GCI Account Information

Required fields are indicated with an asterisk (*).

Last Name*: Account Currency*:
First Name*: Withdrawal Amount*: .
Login Username*: Your E-mail*:
GCI Account Number*:

Credit Card /PayPal Information

Required fields are indicated with an asterisk (*).
PayPal Account E-Mail*:

Additional Information

Required fields are indicated with an asterisk (*).
Will you be closing your account?* *
Any comments on our service?