Withdrawal Form

AXNFX Account Details

User ID : Mobile Number:

Beneficiary Name: Full Address:

Withdrawal Details
I wish to withdraw the following amount from my account.
Amount (USD) : Amount In Words:

Bank Account Details

(Your bank account details must match your identification documents)
Beneficiary Name: Bank Name:

Account Number: Branch name and Address:

Country of beneficiary: IFSC Code/IBAN:

Swift Code: Credit Card :

Comments:

Date: Signature:

• This account should be the same name as your AXNFX account name

Please fill in the required details clearly in order to enable transfer without any mistakes, Scan it and
send it to compliance@axnfx.com

FOR INTERNAL USE ONLY

Signature verified Payment release authorized Payment authorized