<form-template><fields><field required="true" type="select" name="request-type" label="Request Type"><option selected="true" value="load-account">Load Account</option><option value="cash-out">Cash Out</option></field><field type="checkbox-group" name="checkbox-group-1755019991980" label="Choose Your Platform" description="Choose which platform your account is with"><option value="Orion">Orion Stars</option><option value="Juwa">Juwa</option><option value="GV">Game Vault</option><option value="Kirin">Fire Kirin</option><option value="Panda">Ultra Panda</option></field><field required="true" type="text" name="username" placeholder="Your Username" label="Platform Username"/><field required="true" type="text" name="quantity" placeholder=" Type amount of money. Example: $10.00" label="Quantity" description="Minimum amount $10.00"/><field required="true" type="select" name="payment-method" label="Payment Method"><option value="cash-app">Cash App</option><option value="zelle">Zelle</option><option value="apple-pay">Apple Pay</option><option value="paypal">Paypal</option><option value="chime">Chime</option></field><field type="text" name="cashtag" placeholder="Your Cashtag (if applicable)" label="$Cashtag (if applicable)" description="Enter your $Cashtag if you selected Cash App as a payment Method."/><field type="text" name="text-input-1755019722124" placeholder="$ChimeTag (if applicable)" label="$ChimeTag"/><field type="text" name="paypal-email" placeholder="Your Paypal Email (if applicable)" label="Paypal Email (if applicable)" description="Enter your Paypal Email if you selected Paypal as a payment Method."/><field required="true" type="text" name="phone-number" placeholder="Your Phone Number" label="Phone Number"/><field required="true" type="text" name="email-address" placeholder="Your Email" label="Email"/><field type="textarea" name="message" placeholder="Order Notes" label="Notes"/><field type="hidden" name="rendered-form" value="is_rendered"/></fields></form-template>

Place Order