Application for failed payment

What is your nickname?* Choose your payment method*
Please specify transaction number or mobile number Please specify date and time of failed payment*

Please specify mobile number in international format (for example:+79991234567)

Please specify sum of payment* Please specify your valid e-mail address*

Important! Make sure, that the e-mail address given by you is correct and existing.
Once your issue is resolved, the notification will be sent to that e-mail address.

Please attach screenshot of payment transaction (if possible) and explain in more details, what exactly happened during payment execution.

Important! The more information you give, the faster your application will be considered.

Please confirm, that you are not a robot* Please attach your screenshots

You can attach jpg, png and gif files.
Maximum file size is 2 Mb.

* required information