Wire Transfer Form
Download a blank fillable Wire Transfer Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Wire Transfer Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1WIRE TRANSFER FORM
DATE: ________________________________ AMOUNT: ______________________________________
TRANSFER TO: ________________________________________________________________________
(Name of Financial Institution)
LOCATION: ___________________________________________________________________________
(Physical Address Required for International Wires)
BIC / ROUTING #: ______________________________________________________________________
(Bank Identifier Codes / Swift Codes / Account #)
CREDIT: ______________________________________________________________________________
(Name of Intermediate Financial Institution)
ACCOUNT NUMBER: ____________________________________________________________________
(At Intermediate Financial Institution)
LOCATION: ___________________________________________________________________________
(City and State Required for Domestic Wires)
(Physical Address Required for International Wires)
FINAL CREDIT: NAME: _________________________________________________________________
IBAN / Acct #:_____________________________________________________
(International Bank Account Number) Example: See Back
ADDRESS: ________________________________________________________
(Physical Address Required)
________________________________________________________
SPECIAL INSTRUCTIONS:
REQUESTED BY:
NAME:
______
_________________________
ACCOUNT #
__________
______________
____
ADDRESS:
____________________________________________________
(Physical Address Required)
_______________
REQUIRED VERIFICATION:
MEMBER’S SIGNATURE/DATE:
_________________________________
______
Daytime Phone #:
________
_____________
ID Verification Question #1:
_______
ID Verification Answer #1:
________
ID Verification Question #2:
____________________
ID Verification Answer #2:
_______
ID Verification Question #3:
_______
ID Verification Answer #3:
______________
Wire Agreement Verification:
_________
(Emp. Name & Date)
Second Verification (Emp. Name & Date)
Sent By (Emp. Name & Date)
You may identify the payee or any financial institution by name and by account number or other appropriate identifier. The Credit Union (and other
institutions) may rely on the account or other identifying number as the proper identification, even if it identifies a different party or institution. You
authorize the Credit Union to transfer funds as described herein and debit your account in the amount transferred, plus applicable charges.
Fund/wire transfers may be governed under Regulation E or the Uniform Commercial Code (UCC), Article 4A, dependent upon the nature of the
transaction. If a wire transfer is cleared through the Federal Reserve, the transaction will also be governed by Regulation J.
Wire Transfer @ $15.00 each (Cutoff 3:00 p.m.)
International Wire Transfer @ $30.00 each (Cutoff 2:00 p.m.)
Wire Agreement on File
Second Employee Verification $1,000 and over; member signature
required $25,000 and over
OFAC
Accounts Payable Wire Out GL for loan proceeds
AFTER 3:00PM – WILL GO OUT IN THE MORNING OF THE NEXT BUSINESS DAY
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business