BenchCoin Pre-ICO Contribution Form

BenchCoin Token (BCT) Participation
PRE-ICO CONTRIBUTION FORM

Congratulations! You Qualify For Our Early Bird Seed Round 50% BCT Bonus!

Thank you for your contribution and support!

If you don't yet have a WAVES wallet, please get one as soon as possible at WavesWallet.io so when we distribute the BenchCoin Tokens (BCT), you'll be ready.

BenchCoin Token Price:

The cost of each token is 1.00 EUR, and the minimum contribution is 1.00 EUR.

BenchCoin Token Pre-ICO Bonus Schedule:

Contribution Amount > 10,000 EUR = 50% Bonus + SAFT Option*
Contribution Amount > 1,000 EUR = 50% Bonus
Contribution Amount > 100 EUR = 40% Bonus
Contribution Amount > 1 EUR = 30% Bonus

*Please email us at support@hfbbenchmarkico.com for SAFT details.

BENCHCOIN CONTRIBUTION ADDRESSES (BTC/ETH/WAVES)

--- Bitcoin (BTC) Address Below ---

1Fp9GXawuNVTKZdvCCyZLH6hadhGLr9Zki

--- Ethereum (ETH) Address Below ---

0x162386e8a9a92f2b820d34fdad8c2008950d1349

--- Waves (WAVES) Address Below ---

3PHvYr4Zs9K2zBNPqtmCe61TA8n5bJaSTeM

IMPORTANT: Upon sending payment, please fill out the form to inform us about your given contribution amount in the specified cryptocurrency (BTC/ETH/WAVES).

DO NOT SEND payment from exchanges such as Coinbase, Poloniex, Bittrex, etc.

Email *

example@example.com

Contribution Amount in BTC/ETH/WAVES *

Amount of your contribution in cryptocurrency.

Type of Cryptocurrency Contributed *

Cryptocurrency used.

Sender Address (Refund Address)

Your crypto address contribution was sent from.

WAVES Wallet Address (To Receive Your BCT)

*If you do not have a WAVES address yet, leave this blank.

Discount/SAFT Bonus Code

If you have a Discount/SAFT Bonus Code, enter it here.

Additional Comments (If Any)

You are not a U.S. citizen and you agree to ALL Terms and Conditions. *

Yes, I agree.