Withdraw Funds

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Withdrawal Request

Make sure that all information provided is accurate and correct.
Complete and sign the form below, after completion please send to [email protected] for processing.
L2P Brokerage will hold no responsibility for any incorrect information filled below.
All charges imposed by the bank or Online banking will be charged to the beneficiary.
L2P Brokerage does not allow funds to be sent to a third party.
Your request will be processed within two working days of receiving this form.
The client hereby authorizes L2P Brokerage to transfer the funds requested in respect to the instructions below.

First Name:

Middle Name:

Last Name:

Telephone:

Email:

Account Log in # :

Amount in words:

Amount in Numbers:

Bank Name:

SWIFT:

Bank Address:

Account Number:

IBAN:

Are You Closing your existing account?

Yes

Name:

Date: