ACU Western Union Form
Western Union Form
Date
Time
Phone
Mail
In Person
Fax
Other
(specify)
Amount
Fee
Request Taken By:
Member Verfication
Name
Password
SSN
Address
Phone Number
Other (specify)____________________
Originator
Member Information
Member Name
Member Number/S Type
Member Street Address (PO Box not accepted)
City
State
Zip
Member Phone Number
Members ID info
Member Occupation
Member SSN
Beneficiary Pickup Location Information
Pickup Location Information
Pickup Location
Pickup Location Street Address (PO Box not accepted)
City
State
Zip
Pickup Location Phone Number
Beneficiary Information
Name as Printed on ID - Photo ID required for amounts over $999.99
Beneficary Street Address (PO Box not accepted)
City
State
Zip
Code Word or Question if Beneficiary does not have ID (only transactions less than $999.99)
OFAC Verification
Physical Description of Beneficiary for Transactions from $500 to $999.00
Authorization
Signature and picture ID required
Member Signature
Date
For ACU use only
Employee Signature - Input in Sunpower
Sequence #
Employee Signature - 2nd Verification/Call Back
Employee Signature - 3rd Verification