Are you ready to join High Def Riches and be one of the exclusive?
Then complete the application form below and hit the 'Submit' button. Please note that every field marked with an asterisk must be completed.
Once you have submitted the form you will be required to activate your account via a link that will be emailed to the address you have supplied.
WEB SITE INFORMATION:
CONTACT INFORMATION:
First Name:
(required*)
Last Name:
(required*)
Company Name:
E-Mail:
(required*)
ICQ:
Phone Number:
PAYMENT INFORMATION:
Address Line 1:
(required*)
Address Line 2:
City:
(required*)
State/Province:
Zip Code:
(required*)
Country:
(required*)
IMPORTANT!
If your country is not on the list and you wish to promote
HighDefRiches.com please contact us
Tax ID/SSN:
NOTE!
The Tax ID/S.S. # field must be formated as follows.
The numbers must contain dashes.
Tax ID: (xx-xxxxxxx) S.S.#: (xxx-xx-xxxx). !!! USE DASHES !!!
FUNDS DISTRIBUTION:
Method:
Check
Wire Transfer
ePassporte
(required*)
Minimum Payout:
(required*)
Check Payee:
(required*)
Minimum Payout:
(required*)
Beneficiary Name:
(required*)
Correspondent Bank Info (if any) :
Bank Name:
Address Line 1:
Address Line 2:
Bank SWIFT:
Account Number:
Beneficiary Bank Information (required) :
Bank Name:
(required*)
Address Line 1:
(required*)
Address Line 2:
Bank ABA/Routing
or Swift:
(required*)
Account Number:
(required*)
Minimum Payout:
(required*)
ePassporte:
@epassporte.com
(required*)
Note: Minimum payouts are as follows:
- Check - $100.00
- ePassporte - $100.00 ($2 Fee)
- Wire Transfer - $1000.00 (Wire transfer fee is $15 US / $45 International)
