Account Sign Up | Cosmo Payment

COSMO PAYMENT APPLICATION

Please fill out the following form. Do not forget to upload an image of your valid Government Issued ID or Passport as well as a Proof of Address dated within 3 months, and which clearly shows the 4 corners of the page.

Upon submission someone from the Cosmo team will contact you within 72 business hours.

Please upload a clear photo of your valid Government Issued ID or Passport as well as a Proof of Address dated within 3 months, and which clearly shows the 4 corners of the page.

First Name

Last Name

Birth Date

Address

City

State/County

Postal Code

Country

Phone Number

Please insert estimated monthly payout volume in USD

Please list all websites who will be funding your account

Please input links to your website profiles

Passport or Government ID

Upload

Proof of Address

Upload

Already have a Cosmo card? Add the 9 or 10-digit SAN found on the back

I have read and agree to the CardholderPrivacy Policy

Add answer here