Fillable Wire Transfer Form printable pdf download

RECEIPT OF WIRE REQUEST-CUT OFF TIMES:

Fedwires:

WIRE TRANSFER FORM

U.S.

3:00 p.m. EST

2:00 p.m. over $5,000 EST

Email to:

International:

11:00 a.m. EST

Fax to: 336-332-4573

Western Union: 3:30 p.m. EST

Within U.S. $20 Fee Outside U.S. $45 Fee

Western Union Wire Fees vary based on amount

Member/Account Number: _______________________________________________ Savings

Checking

Time: ______________________ Date: __________________________________ Home Phone: ____________________________

Member Full Name: __________________________________________________ Work Phone: ___________________________

Member’s Physical Home Address: _______________________________________________________________________________

Receiving Bank: _______________________________________________________ Wire Amount $__________________________

Receiving Bank’s Address: ______________________________________________________________________________________

Receiving Bank ABA# __________________________________________________________________________________________

REQUIRED FOR Wires to Europe: IBAN Number: _____________________________ SWIFT or BIC Code: ______________________

Receiving Bank – City _____________________________ Country______________________________________________________

Receiving Account Information (Beneficiary): _______________________________ Account Number: _______________________

Receivers Full Address (not a PO Box): ____________________________________________________________________________

For Further Credit To Second Bank (if Necessary): ____________________________ SWIFT or BIC Code: ______________________

Bank’s Address:

________________________________________________________________________________________

Additional Information: ________________________________________________________________________________________

_______________________________________________________________________________________

If you send or receive a Western Union Wire or Wire Transfer, Fedwire may be used. Regulation J is the law covering all Fedwire

transactions. If you give Acclaim Federal Credit Union a payment order which identifies the beneficiary (recipient of the funds) by

both name and identifying or account number, payment may be made by the beneficiary’s bank on the basis of the identifying or

bank account number, even if the number identifies a person different than the named beneficiary.

If you give Acclaim Federal Credit Union a payment order which identifies an intermediary or beneficiary’s bank by both name and

an identifying number, a receiving bank may rely on the number as the proper identification even if it identifies a different person

than the named bank.

Member Signature: _____________________________________________________________ Date: ________________________

Acclaim Federal Credit Use Only:

Member Services Department Use:

Verified Info:

Emp. Int.

Mbr. ID Used:

Emp. Int.

Form/ID Signature Compared

__________

Photo ID ___________________

__________

Mbr Funds withdrawn (owt.owu) __________

Password ___________________

__________

Outgoing Fee Charged (owt/wu)

$_________

OFAC Verification ____________

Request Forwarded to Accounting Dept. _________________Time________________________ Date___________________

Manager’s Int + $1,000 _______________

Sr. Manager’s Int. + 10,000 _______________

Accounting Department Use:

Call Back Information (initials) __________

Member Provided Password: (Yes/No) _____________________

Phone # called _____________________

FCCCU Number/MCTN: _____________________________________________

Processed on FCCCU: Time: _________________________________________

Date: ____________________________________

Verified by (Initials): __________

General FormsAcclaim Wire Transfer Form.pdf

Wire Transfer Form

Related Articles

Related forms

Related Categories