CI Wire Transfer v
.18.01
Wire Transfer Request
Form
S
e
n
d
e
r
'
s
I
n
f
o
r
m
a
t
i
o
n
Accounts Payable Completes
Wire Amount (Credit)
Bank Name:
R
e
c
e
i
v
e
r
'
s
I
n
f
o
r
m
a
t
i
o
n
Bank
Address:
Bank
Routing No:
Receiver Account No:
Receiv
er's Name:
Receiv
er's Address:
Reference/Memo:
Pre
pared by & Date:
Approved by & Date:
Wire Initiated by & Date:
Wire Approved by & Date:
Account Number
Account Name:
Address:
Date of Wire: