טופס בקשה להמרת צ'יפים

תאריך הגשה

Full name

Email

Cell phone

Prize amount

of the user (guest) in the club

Club user number (P****-****) - optional

Amount of chips to convert (100,000-1,000,000)

How to receive the award

ID card including audit (9 digits)

Bank account details: account beneficiary name, bank name, branch number, account number

Signature of the award recipient

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