Withdraw Request - Credit Card

After you complete this form, click Print-friendly for a printable version. You must 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 here .


GCI does not charge for sending payments, however transfer fees are applied by our payment system provider. Forms submitted with missing information are subject to delay.


Required fields are indicated with an asterisk (*).

Your GCI Account Information
Last Name*: Account Currency*:
First Name*: Withdrawal Amount*:
Address 1*: Address 2:
City*: State/Province*:
Country*: Your E-mail*:
Login Username*: Contact telephone number*:
GCI Account Number*:  

Credit Card Information
Type*:
Last 4 digits of card number*:
Issuing Bank Name*:
Additional Information
Will you be closing your account*?
Any comments on our service?

Please complete all required fields