Attachment 43
Last Modified: 04/2020
PROJECT INFORMATION
WIRE TRANSFER REQUEST FORM
This form must be typed. ALL fields are required. Forms with hand-written information and/or
missing required information will be returned to the Fiscal Administrator. Refer to Policy 2.706 for
details on wire transfers.
WIRE PAYMENT INFORMATION
Domestic Wire
Foreign Wire
Currency Type
(Select a currency)
Amount
City and Country
Bank SWIFT Code
Beneficiary/Vendor Bank Account Name
Beneficiary Address
Beneficiary Bank Account Number
Bank Name
Bank Address
Remittance/Reference Information
The $40.00 standard wire fee is always charged to the project.
By checking this box the project agrees to pay for all ADDITIONAL bank fees charged by the
Beneficiary Bank and/or Correspondent Bank(s).
10
3
2
1
Charge the Bank Fee(s) to:
Project Number
Budget Category
A confirmation email will be sent to the Fiscal Administrator on the date of the wire transfer.
FA Name
FA Email
Attachment 43
LastModified:04/2020
NOTES
TheAttachment43isaninteractiveform;thereforesomeendnotesmaynotappeardependingontheselectionof
DomesticWire,ForeignWire,orCurrencyType. RefertoPolicy2.706fordetailsonwiretransfers.
1
WiretransfertoabankaccountlocatedintheU.S.
2
WiretransfertoabankaccountlocatedoutsidetheU.S.
3
OnlyapplicabletoForeignWires. RCUHisabletowirefundsonlyinthecurrencytypeslisted.
4
OnlyapplicabletoForeignWiresinU.S.Dollarcurrency. U.S.correspondent(intermediary)bankinformationis
requiredwhenwiringUSDtoaforeigncountry.Requesttheinformationfromthevendor.
5
OnlyapplicabletowiretransfersinU.S.Dollarcurrency. ABAnumber(alsoknownasaroutingnumber)isanine‐digitcode
thatidentifiesbankinginstitutionsintheU.S.
6
Thenamelistedshouldbeanexactmatchtothenameonthebeneficiary(i.e.,vendor)bankaccount. Thebeneficiary
bankaccountnamemustmatchthevendornameonthePO,invoice,and/orpaymentdocumentotherwisean
explanationisrequired.
7
BankaccountnumbersforEuropeanandMiddleEasterncountriesarereferredtoasanIBAN(InternationalBank
AccountNumber). TheIBANconsistsofanalphabeticalcountrycodeandalphanumericalcharactersthatidentify
thebankandtheaccountnumber. Ifapplicable,listthefullIBANnumber.
8
OnlyapplicabletoForeignWires. SWIFTorSWIFTBICcodeisaninternationalbankcodethatidentifiesbanksandfinancial
institutionsworldwide.
9
Informationtoberelayedtothevendorwiththewiretransfer(e.g.,PO#,invoice#,account#,etc.). Duetospace
limitationwhensendingawiretransferthisinformationcouldbetruncatedoromitted.
10
Thestandardwiretransferfeeis$40.00andisalwayschargedtotheproject. TheBeneficiaryBankand/orU.S.Correspondent
Bank(s)maychargeadditionalfeestothevendorwhichcoulddecreasethefinalamountreceivedbythevendor.By
checkingtheboxtheprojectagreestopayforallpossibleadditionalbankfees. These
additionalbankfeesareunknownat
thetimeofthewiretransferandareusuallychargedtotheprojectwithinonetofourweeksafterthewiretransferdate.