Request insurance
(If we check and realize any of informations you have provided is incorrect, We reserve the right to refuse the guarantee payment. So the infomations you provide is completely accurate.)
Projects *
Username/email (login) *
Your answer
Password *
Your answer
Deposit date *
MM
/
DD
/
YYYY
Amount deposit *
Your answer
Amount RCB paid (Include Bonus) *
Your answer
Amount withdrawn *
Your answer
Wallet address *
Your answer
Your contact (Telegram/Skype) *
Your answer
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