OXAIXO USDD

Reseller partner Application

reseller ID

Company Name

First Name

Last Name

Password

Password Check

Email

Email Check

Country

Mobile Number

Class Reseller Partner

Partner Company Homepage

Manager

Company Phone

City

State

Address

Zip-Code

Bank Information in English

Beneficiary Bank Name

Beneficiary Bank Address

SWIFT Code

Beneficiary Name

Beneficiary Address

IBAN or ABA No

Beneficiary Account Number

Intermediary Bank Name

Intermediary Bank Address

Intermediary SWIFT Code

Intermediary IBAN or ABA No

Intermediary Bank Beneficiary's Account Number

Special Instruction

Bank Information in Native language

Bank Name

Account Holder

Account Number

Terms and conditions Terms and conditions

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