BANK DEPOSIT

FIRST NAME *
TELEPHONE *
EMAIL *
BENEFICIARY'S FIRST NAME *
NAME OF BENEFICIARY *
RECIPIENT'S PHONE NUMBER *
RECIPIENT'S DOCUMENT *
BENEFICIARY'S DOCUMENT NUMBER *
COUNTRY *
DEPARTMENT/REGION *
TOWN *
CURRENCY *
BANCO *

ACCOUNT TYPE

 *
ACCOUNT NUMBER *
AMOUNT *
select, }