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
If Applicable:
(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)