Bulenox LLC Withdrawal Information Form

Bulenox LLC Withdrawal Information Form
Please complete the withdrawal information form for future Withdrawals. The name and address must match the Master Account agreement.

Withdrawals may only be processed to a bank account or payment method located in the country of the trader’s residence.

*Please resubmit the form If any of the personal information will be changed in the future.
Name

First NameLast Name
Company (Optional)
(Optional)
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Email
example@example.com
BX ID
Please Attach:

1. Copy of government-issued ID (DL or Passport)

2. W-9 (US traders) or W-8BEN (Non-US Traders)
Cancelof
Please choose Preferred Method of Withdrawal:

Withdrawal could be requested via: Paypal, WISE, ACH, Wire Transfer
Important: If your bank account number or routing number begins with 0, please insert a hyphen after the leading zeros. For example, if the number is 00123456, it should be entered as 00-123456.
1. PayPal Email Payout
PayPal transfers may not be approved. In such cases, bank account details will be required.
2. ACH Transfer (United States Bank, Wise) Payout

Name of Bank

Bank Routing Number

Account NumberState / Province

Postal / Zip Code
3. Wire Transfer (International) Payout

Account Number

Routing Number/ International SWIFT (Bank SWIFT only)

Street AddressCity

Postal/ Zip CodeCountry
4. Crypto USDT Wallet
Limit $2000 per payout and $3000 per month
4. Venmo Payout
Email or phone number
Signature
Date

MonthDayYear
Date
Should be Empty:

Bulenox LLC Withdrawal Information Form

Please choose Preferred Method of Withdrawal: