Following the directions was easy. US purchaser, used iPhone. Instructions provided links for 2 different VPNs both available on Apple or Android and several keys for Xbox live gold subscriptions and a final key for game pass ultimate (which converts the total time to game pass ultimate). I chose to use the Surfshark VPN; had to sign up for 12 month paid subscription to get 7 day free trial. As soon as keys were redeemed, I cancelled subscription (seller provides instructions for this too), so no charge was processed for this VPN use. When using the final key to convert to game pass ultimate Microsoft requires a payment method for recurrent billing, I used one of my US cards on my PayPal account (while still on VPN). Though once the process was completed, I turned off the recurrent billing. I signed on the Microsoft Xbox site on my US PC without VPN and it shows my subscription to be current through the next 3 years. Very pleased!
P.S. I think it's possible to set up and sign on to your Xbox account with an Apple ID, which may have something to do with the previous reviewer's issue?? My Xbox account ID has been a Microsoft sign on for many years and I had no issues with payment or email account regions.