Go4rex.

com
DEPOSIT CONFIRMATION AND AUTHORIZATION FORM

Transaction ID Date Amount Card Number Deposit

(the ID from the payment (the date of the deposit) (the amount of the deposit) (last 4 digits of the credit (Please write how
confirmation e-mail) card you made the deposit you deposited the
with) funds by writing
Cash or Online
Payment)
Go4rex.com

Go4rex.com
Date:

/ /

By signing the below, I hereby declare:

1. I confirm that I have read, understood and agreed to the Terms and Conditions
described on https://www.go4rex.com/about-us/legal/terms-and-conditions/

2. I have received all services/software/tools I have signed up for as described on

WWW.Go4Rex.COM and the pages affiliated to it.

3. I understand and agree with the kind of service I will receive from
WWW.Go4Rex.COM and I am fully aware of the risks within the services
described on https://www.go4rex.com/about-us/legal/risk-disclosure/

4. I , Confirm and acknowledge that I have authorized and

issued the above stated transactions to WWW.Go4Rex.COM for CFD, Forex or any other
trading offers and that all the deposits above were made by me personally.

Signature: Name :