Beneficiary (Payee) Information For Controller's Office Use Only
Name Tracking #
Address Date Sent
Sent By
Approved by
Attn/Special Note (optional) Approved by
Beneficiary Bank Information (Payee's Bank)
Bank Name
Bank Address
Bank Account# or IBAN
Swift Code
Sort Code (If Applicable)
Amount
(An Intermediary Bank is used if the Beneficiary Bank does not accept US Dollars)
Intermediate Bank Information
Bank Name
Bank Address
Swift Code
Beneficiary Bank's Acct # at this Bank
Controller's Office Use Only
Converted Currency Amount
(To be completed at time of transfer by Controller's Office)
*Should you have any questions or concerns, please contact Billy Pollard (x-3025) or Mandy Redfearn (x-3027).*
Revised 06/27/2017
Currency-USD, EUR, JPY, CAD, etc:
University of West Florida International Wire Transfer Form
(Note: City and State/Country are REQUIRED information for the bank address)