Redeem Coins

[contact-form to=”[email protected]” subject=”Coins Redeem Request – Gofferkart India”][contact-field label=”Name” type=”name” required=”1″][contact-field label=”Your Registered Email Id” type=”email” required=”1″][contact-field label=”Paytm Registered Number (KYC Verified)” type=”text” required=”1″][contact-field label=”Re Confirm – Paytm Registered Number (KYC Verified)” type=”text” required=”1″][contact-field label=”Coins to withdraw?” type=”select” required=”1″ options=”10000,40000,40000,100000″][contact-field label=”Request Date” type=”date” required=”1″][contact-field label=”The information, which i have provide is 100% correct and no further changes required on my above details.” type=”radio” required=”1″ options=”Agreed ,Disagreed”][/contact-form]

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