TRANSFER REQUEST FORM
ARKANSAS STATE TREASURY MONEY MANAGEMENT TRUST
Please complete this form and return to the Arkansas State Treasury’s Office via email.
Email: MMTrust@artreasury.gov
Contact: STMMT Administrator (501-682-1291)
P
lease complete this form to transfer funds from one STMMT Account into another STMMT Account.
Participant Name:
Request Date: ____________________ Transaction Date:
Participant's Phone Number:
Participant’s Email:
Transfer Amount:
To STMMT Account #:
From (Other STMMT Account Name): __________________________________________
From STMMT Account #:
Authorized by:
____
__________________________________ ______________________________________
Signature Title
____
__________________________________ ______________________________________
Please Print Name Date
__________________________________________________________________
FOR TRUST USE ONLY
T
icket #___________
C
orrespondent
Bank Name__________________________________________________________
Bank T/R #_________________________ Account Balance__________________
Correspondent Bank T/R#_______________________________________________
