Accounts Payable AP01
Wire Transfer Request Form
Purpose of Form: This form may be used by anyone on campus, except for students, to send a payment to a
vendor. This form is not for student payments. Students use Student Wire Request Form AR11.
_________________________________________________________________________________________________
All information requested is mandatory. Delays may occur if any pertinent information is missing.
Payee Information
Banking Information
Page 1 of 2
Payee Name ________________________________________________________________________________
____________ _____________________
Payee Address __________________________________
Date _______________ Amount ______________ Currency _____________
Purpose of Wire/Message to Payee: _____________________________________________________________
Bank Name ________________________________________________________________________________
Bank Address ___________________________________ ____________ ______________________
Street number and name
Unit/Apt
City
Province/State Postal/Zip Code Country
IBAN/Bank Account Number
___________________________________________________________________
Swift Code _________________________________________________________________________________
Routing Code or ABA Number _________________________________________________________________
____________
_____________________________
_________ __________________
Street number and name ni City
Province/State
Postal/Zip Code Country
Unit/Apt
_________
________
____________
_____________________________
_________ __________________
_________
________