University Of Windsor Wire Transfer Request Form

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Wire Transfer Request Form
All information requested is mandatory. Delays may occur if any pertinent information is missing.
Date : _______________
Amount : _______________
Currency : _______________
Purpose of Wire / Message to Payee: ____________________________________________________
Payee Information
Payee Name :
____________________________________________________________________
Payee Address
________________________
________________________
________________________
Street Number / Name
Unit / Apt
City
________________________
________________________
________________________
Province / State
Postal / Zip Code
Country
Banking Information
Bank Name :
_____________________________________________________________________
Bank Address
________________________
________________________
________________________
Street Number / Name
Unit / Apt
City
________________________
________________________
________________________
Province / State
Postal / Zip Code
Country
IBAN / Bank Account Number:
_______________________________________________________
Swift Code:
_______________________________________________________
Routing Code or ABA Number:
_______________________________________________________
Accounting Information
Business Unit
Object Account
Sub Object
Amount
Requested By :
_________________________
Signature :
_________________________
Approved By :
_________________________
Signature:
_________________________

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