WIRE TRANSFER FORM
Name of Person Preparing Form & Department
This must be the exact name & address on the
payee’s bank account.
(Record amount to be wired in the currency indicated on
Wire Instructions – Attach wire instructions from payee’s bank.
Bank ABA Number*
Bank Account Number**
BIC (Swift Code)**
Sort Code (UK Only)**
Intermediary Bank Information
(ABA Number & SWIFT Code)^
Additional Payee Payment Instructions
# Suppliers are encouraged to sign up for ACH/Direct Deposit. Domestic Wires are not encouraged and require
the approval of the Director of Disbursements.
* ABA required for domestic wire transfer.
** See the Wire Transfer Policy for definitions
^ If the receiving bank’s wire transfer instructions specifies the use of an intermediary bank, record that
Wires to India and China require the
business purpose/reason for the wire and
the relationship between the remitter
(Brown) and the beneficiary (payee).