WorldRemit Recipient Input Form

Input blanks below.
Names must be the same as your ID.
All data transfer is protected SSL coded.

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First Name
Middle Name
Last Name
Address Line 1
Address Line 2
Suburb
City / Town
Province
Country
Mobile Phone Number
E-mail address
Cash Pickup
Bank
Other Bank Name
Account Number
ID with your face printed, attach here
After inputting the form, tap the blue bar below.
このフォームは、SSL暗号化通信に対応しています