GATE TO PAY

World Prepaid Card

Jordanian Form

Based on internal rules and regulations of Gate to Pay, we have the right to accept or decline any request without giving the reasons

First name

Last name

Name on card

Date of birth

Nationality

National number

Country Of Residence

City

Area

Street

PO.Box

PostalCode

Phone number

Alternative phone number

Email

Civil ID (Front side)

Civil ID (Back side)

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