Compass Card, International Pre Paid Card, funds transfer, card to card,caribbean bank

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WE MUST ALSO RECEIVE THIS PDF APPLICATION BY EMAIL OR REGULAR MAIL, WITH ID AND UTILITY BILL APPLICATION
THOSE WHO CANNOT PAY ONLINE MAY USE THIS FORM TO SEND AN INTERNATIONAL MONEY ORDER AND REQUIRED DOCUMENTS Please include first minimum load of $50.

You are visiting us today from IP ADDRESS: 38.103.63.59

Personal Information :

Title First Name MI Last Name

Date of Birth

Address

City State/Region

Zip/Postal Code Country

Email Address

Do not enter leading zeros for country codes or area code portions of the phone number.

The first field is for the Country Code, not the Area Code!
FOR USA: COUNTRY CODE = 1
Enter the Area Code and Phone Number together in the second field.

Country Code Area Code & Phone No.

Example: USA +

Example: UK +

Daytime +

Evening +

Cell +

Select Plan

One (1) Compass Card - USD $30.00

I choose to pay by
Check (USA only)

Help

Your Name on Account

Bank Name

Account Type

Routing Number (No Spaces or Dashes)

Account Number (No Spaces or Dashes)

I choose to pay by
Credit Card - (VISA or MASTERCARD)

Name on Card

Type of Card

Credit Card Number (No Spaces or Dashes)

Expiration Date (mm/yy)

CVV

"Virtual" credit cards are NOT acceptable. You may be asked to provide a scan/copy of your credit card before this order will be processed. Fraudulent credit card orders will result in immediate suspension of the account. Fraudulent transactions are reported.
First load of $50 must also be made through eWalletPlus.com within 48 hours of this order.

I choose to pay by eWalletPlus
eWalletPlus Username

I choose to pay by sms/text message
Mobile Phone Number

Available to mobile phone users in Denmark, Finland, Great Britain, Ireland, Netherlands, Norway, and Sweden. Help

Agreement
All fields are required and must be filled in to process this application. Incorrect or missing information will delay the processing of your order. Please make sure your personal information is correct. The information submitted will never be sold to or made available to third parties. We will use this information to process your application and maintain a relationship with you. Our staff is available for phone support at: +44 207 043 1183 First load of $50 must be made through eWalletPlus.com within 48 hours of this order.

By checking this box I have read and agree to all the terms and conditions relating to this application on http://www.compasscard.net/ and I am of legal age in my country of residence. Cardholder Information: all fields are required and color notorised copy of passport and a utility bill must accompany the pdf form or be emailed to: support@compasscard.net
For US Citizens ONLY: By signing this application I confirm that I am aware that I may be required to disclose the existence of this card to the IRS or other Governmental authority in the United States and agree that I will do so as required by law. I acknowledge that failure to do may result in cancellation of my card.