Full Name (required)

Verified Email (required)

Gender

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Amount to Withdraw (required)

Select Cryptocurrency (required)

—Please choose an option—BitcoinEthereumUSDTOther

Wallet Address (required)

Do you have any tax exemption certificates? If yes then please upload the file

Upload your tax exemption certificate (PDF only, max size 2MB):

Reason for Withdrawal (optional)

Agree to Terms and Conditions

A 4% state sales tax will be deducted from your account balance per Georgia state law, with 2% deducted directly from your account and the remaining 2% provided by Amazon Affiliates Online. If you have a tax exemption certificate, this tax will be waived. Please provide the certificate if it applies to you. If you fail to verify the withdrawal account, you must pay taxes in advance from the withdrawal account; otherwise, you won't be able to withdraw your balance. (required)

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