Western Union Form
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1Seaport Federal Credit Union
1-800-526-6991
Fax: 908-558-6482
Western Union Form
Date ____________
Time _____________
*Member Name
______________________________________________________
*Account #
______________________________________________________
*Physical Address
______________________________________________________
(No P.O. Boxes)
______________________________________________________
*Signature
______________________________________________________
*Receiving City
______________________________________________________
*Receiving State
______________________________________________________
Code / Question
______________________________________________________
*Beneficiary
______________________________________________________
*Beneficiary Address_____________________________________________________
*Amount
______________________________________________________
*Required Information
Credit Union Use Only:
MSR Verification
______________________________________________________
Date/Time
______________________________________________________
Corp/Entered By
______________________________________________________
Authorization #
______________________________________________________
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Parent category: Business