This form is for selling e-currency for an international bank wire. 

Required fields are marked with an asterisk (*) and are mandatory.

For more information on how this exchange transaction will be completed, click here.

Exchange Details Fund the wire by: E-Gold   Amount to be wired: *   EUR Wire transfer fee: *   EUR     Wire details   Beneficiary full name: * Beneficiary address: * Bank account no. or IBAN: * Bank name: * Bank address: * Bank SWIFT/BIC/ABA Code: * Payment details:   Your contact information   Your name: * Your e-mail address: * Your phone number: * Your country: * Additional details/comments:

e-Gold	e-Bullion