Fillable BROWN UNIVERSITY WIRE TRANSFER FORM This must be (Brown University)

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BROWN UNIVERSITY WIRE TRANSFER FORM This must be (Brown University)

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Country of origin: US
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BROWN UNIVERSITY
WIRE TRANSFER FORM
Today’s Date
Date Payment Required
Name of Person Preparing Form & Department
Payment Type
Domestic Wire
(USA)#
International Wire
Payee’s Name & Address
This must be the exact name & address on the
payee’s bank account.
Payment Amount
(Record amount to be wired in the currency indicated on
invoice.)
Wire Instructions – Attach wire instructions from payee’s bank.
Bank Name
Country
Bank ABA Number*
Bank Account Number**
(IBAN, if required)
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
information here.
Wires to India and China require the
business purpose/reason for the wire and
the relationship between the remitter
(Brown) and the beneficiary (payee).
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BROWN UNIVERSITY WIRE TRANSFER FORM This must be (Brown University)

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Completed 10 March 2022

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