USAGC GREEN CARD PAYMENT OPTIONS - Bank Transfer
Bank transfer

You may pay via wire transfer in US Dollars or Euros. Please transfer the money to the account specified below. After you completed the paymen,t please fax this form to:1-202-318-4492.

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PLEASE WRITE VERY CLEARLY USING ONLY CAPITAL (BIG) LETTERS

First name: Last name:
Country: Phone(optional):
E-mail address:
Confirm e-mai (indicate e-mail again):
Account number  (mandatory):

Beneficiary account:
Name: USAGC ORGANIZARION LTD

Beneficiary bank:
Bank of Valletta p.l.c.
International Clients Centre, Level 4, No. 45, Valletta VLT111, Malta
Swift code: VALLMTMT
EUR
Account number: 40019302607
IBAN: MT44VALL22013000000040019302607
USD
Account number: 40019302610
IBAN: MT60VALL22013000000040019302610
MARFIN LAIKI BANK
Swift Code: LIKICY2N
IBAN: CY15-0030-0179-0000-0179-1108-5836 (Euro)
Address: 205 Makarios III Avenue, Victory House, CY-3030, Limassol, Cyprus

Client payment information:
Sender's first name:
Sender's last name:
Country of payment:
Amount transferred:

Name of sales person/agent in the USAGC (optional):



PLEASE WRITE VERY CLEARLY USING ONLY CAPITAL (BIG) LETTERS

Mark with X: Select service: Price:
Your application for 1 year €64
Your application for 2 years
€124
You & Your husband/wife applications for 1 year /font>
(Double your chances of winning)
€104
You & Your husband/wife applications for 2 years
(double your chances of winning)
€184
Your application for 4 years
€234
You & Your husband/wife applications for 4 years
(double your chances of winning)
€354
Your application for 10 years
€454
You & Your husband/wife applications for 10 years
(double your chances of winning)
€574
Please note that all listed prices include the extra €5 for processing and handling.

By signing below you accept and agree to the USAGC Organization's "Terms and conditions" as published on the www.usagc.org website.

I READ, ACCEPT AND AGREE:
________________ ________________
SIGNATURE DATE

After completing all details fax this page to:
Fax: +1-202-318-4492
or
e-mail to: support@usagc.org


PLEASE NOTE:

  • Please make sure you have completed the payment before sending this form.
  • Please note that all listed prices include the extra €5 for processing and handling. You have to send the listed amount and not add any other amount. USAGC will not return any change or refund any payment once it has been received.