Debit Card Registration Form

Please fill out the form below carefully as we and our partners at DaricPay will use this information to stay in touch with you in the process of your tourist debit card. We will also send an email confirming the submission of your application, or an email confirming the purchase of your debit card.

General Info

First and Middle Name

Last Name

Gender

Birth Date

Father's First Name

Nationality

Contact Info

Phone Number Please enter your phone number in international format without any dash or space.

Passport Info

Passport Number Please enter your passport number without any dash or space.

Issue Date

Expiration Date

Passport Scan

Choose file

Delivery Info

Estimated Arrival Date

Where do you prefer to get your card?

Flight Number

Payment Method

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