Admiral Markets UK Ltd 16 St Clare Street London, EC3N 1LQ United Kingdom Tel: +44 (0)20 7726 4003 Email:
[email protected] • Client information Client information. Please fill in carefully in print. Name: Surname: Current date:
• Trading account information Trading account #:
Phone Account Password:
• Contact information Telephone:
Email:
• Withdrawal amount The sum to be withdrawn:
,
• Payment details:
Please fill in very carefully in print. Admiral Markets UK Ltd does not bare any responsibility for incorrectly filled in payment details, and as consequence – for the incorrectly executed Withdrawal Request. Beneficiary’s Name: Beneficiary’s address: Beneficiary’s Name: Bank name:
SWIFT:
Bank address (City or state, Country):
• Trading Account Your Trading account will not be closed until you have funds left on it .
Do you wish to close your Trading Account? If YES, please check the box:
Print name:
Client signature:
Date:
Admiral Markets UK Ltd Registered Address: As Above Registered Number: 08171762 Authorised and Regulated by the Financial Conduct Authority FRN: 595450
Admiral Markets UK Ltd 16 St Clare Street London, EC3N 1LQ United Kingdom Tel: +44 (0)20 7726 4003 Email:
[email protected] Admiral Markets UK Ltd Registered Address: As Above Registered Number: 08171762 Authorised and Regulated by the Financial Conduct Authority FRN: 595450