Bank Deposit Form

First Name (Required)

Last Name (Required)

Your Email (Required)

Date of Birth (Required)

Phone Number (Required. Please include area code)

Hai Ha Money Transfer bank accounted you've deposited funds into (Required)

Deposit Method (Required)

Amount Deposited (Please include the total amount you've deposited into our account)

Transaction Reference # (This unique reference # is provided to you by our consultant to ensure that your deposit can be cleared as soon as possible. If you do not have one please contact us before you deposit the money. Otherwise, your deposit may take longer to be cleared)

Date Deposited (Required)

Transactions Details: (Please include the name, address/bank details and telephone number of the beneficiary, plus which currency you would like them to receive)

Your Message

captcha
Input the code above: