BANKING INFO

Please fill in the form below with your personal payment information. Please be careful and make sure the information is accurate.

Please have your Bank Name, Address, Routing Number, Account Number handy when filling out this form.

Name on your account

First Name

Last Name

Your email address

Your phone number

Country

(###)

###

####

Bank Name

Address

The address of your bank, NOT your personal address.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Account type

Personal Checking

Savings Account

Business Checking Account

Other

Routing Number

First set of numbers on the lower left side of your checks

Account Number

Second set of numbers on the bottom of your checks

SWIFT Code (wires only)