Wire Transfer Instructions and Authorization Form

To submit this wire transfer form, please ensure all required fields are completed. You can email the form to transfers@yourbank.com or fax it to (555) 123-4567. If you prefer, visit your local bank branch to submit the form in person.

For 2024 and 2025, ensure you submit wire transfers before cut-off times for same-day processing. Be aware of bank holidays which may affect transfer times. Keep track of any relevant deadlines imposed by your financial institution.

The primary purpose of this wire transfer form is to facilitate secure and efficient monetary transfers. It ensures that all necessary information is captured to execute the request accurately. By standardizing the information captured, banks can provide better customer service and avoid errors.

• 1. REQUEST RECEIVED: Date and time the request was received.
• 2. CALL BACK PHONE#: Contact number for confirmation.
• 3. CALL BACK PERFORMED BY: Individual confirming the transaction.
• 4. DATE & TIME: Date and time of the transaction.
• 5. CHECKED WITH OFAC/FINCEN: Verification against OFAC/FINCEN lists.
• 6. WIRE TRANSFER FORM: Document indicating it is a wire transfer request.
• 7. International Wire Fee:: Fee for international wire transfers.
• 8. Domestic Wire Fee:: Fee for domestic wire transfers.
• 9. Our Customer Info: Details pertaining to the customer making the request.
• 10. Branch #:: Identifying number for the bank branch.
• 11. Debit Account #:: Account number that will be debited.
• 12. Customer Name:: Name of the customer making the request.
• 13. Customer Address:: Address of the customer.
• 14. City/ST: City and state of the customer.
• 15. Zip: Postal code.
• 16. Bank Info: Information about the recipient's bank.
• 17. ABA#:: ABA routing number for the bank.
• 18. Bank Name:: Name of the recipient's bank.
• 19. Bank Address:: Address of the recipient's bank.
• 20. City/ST: City and state of the recipient's bank.
• 21. Zip: Postal code of the recipient's bank.
• 22. Amount:: The amount of money to be transferred.
• 23. $: Indication of the currency.
• 24. Beneficiary Info: Details about the recipient of the funds.
• 25. Acct Number:: Account number of the beneficiary.
• 26. Name:: Name of the beneficiary.
• 27. Address:: Address of the beneficiary.
• 28. City/ST: City and state of the beneficiary.
• 29. Zip: Postal code of the beneficiary.
• 30. Further Credit Info.: Additional information for crediting further beneficiaries.
• 31. Account Number:: Account number for further credit.
• 32. Name: Name of the further credit recipient.
• 33. Address: Address of the further credit recipient.
• 34. City/ST: City and state of the further credit recipient.
• 35. Zip: Postal code of the further credit recipient.
• 36. ORIGINATOR AUTHORIZATION AND ACKNOWLEDGEMENT OF DISCLAIMER: Statement acknowledging the transfer authorization.
• 37. DATE OF WIRE TRANSFER ORDER: Date when the order was placed.
• 38. AUTHORIZING SIGNATURE OF ORIGINATOR: Signature of the individual authorizing the transfer.
• 39. Request taken by:: Name of the individual taking the request.
• 40. Officer Approval Signature:: Signature of the officer approving the request.
• 41. For Wire Transfer Dept Use: Section for internal use by the wire transfer department.
• 42. Entered by: Name of the employee entering the information.
• 43. Verified by: Name of the employee verifying the information.
• 44. $.01 - $50,000.00: Transfer amounts that can be processed.
• 45. $50,000.01 - $250,000.00: Range of transfer amounts.
• 46. $250,000.01 & up: High-end transfer amounts.
• 47. Employee: Identification of the internal employee.
• 48. 1 VP or higher: Approval levels required for transfers.
• 49. 2 VP's or higher: Higher approval requirements.
• 50. Exception to policy Yes: Indication of policy exceptions.
• 51. No: Indication of standard procedure compliance.
• 52. Approved by: Name of the approving authority.

Failure to submit this form may result in delays or complications with your wire transfer request. If not provided, your funds may not reach the intended recipient or could be returned. Always ensure every field is accurately filled to avoid issues.

• Delayed Transfer: Your funds may not arrive on time.
• Inaccurate Information: Errors in your form may cause transfer failures.
• Return of Funds: Incomplete forms can lead to funds being returned.
• Compliance Issues: Incorrect submissions may breach compliance regulations.
• Increased Fees: Errors may incur additional processing fees.

• 1. Personal Transfers: For sending money to family or friends.
• 2. Business Payments: Paying vendors or suppliers.
• 3. International Transactions: Sending money overseas.
• 4. Real Estate Transactions: When purchasing property requiring fund transfers.
• 5. Emergency Funds Transfer: Sending immediate support to someone in need.