Fillable Printable Wire Transfer Request Form

Wire Transfer Request Form

Revised 07/26/2013

Wire Transfer Request Form

To facilitate efficient processing, it is required that the information below is typewritten OR is completed

with the Adobe Acrobat form fill-in capacity. Forms with hand-written information and/or lacking completed

fields will be returned.

Additional instructions are available at:

http://controller.berkeley.edu/disbursements/FAQ/AboutWireTransfers.htm

Beneficiary (payee):

Beneficiary's address:

Beneficiary's e-mail address:

Amount (in words):

Example: Sixteen thousand four hundred thirty-two dollars and sixty-four cents

Amount (in numbers):

Example: $16,432.64

Currency Unit:

Bank name (no abbreviations):

Beneficiary's bank account:

Information about valid formats for bank account numbers is available at

http://controller.berkeley.edu/disbursements/FAQ/WireTransferAccountNumberFormats.htm

Bank address:

SWIFT code of the bank:

Related purchase order or voucher invoice number:

Signature of Authorized Campus Official

Date

Printed Name of Signatory

Title of Signatory

The SWIFT system was designed by an international banking consortium to process secure global electronic

transactions. The SWIFT ID code is an eight or eleven character code that identifies the beneficiary's bank.

Disbursements Office only

Signature of Additional Approver

Date

Printed Name of Additional Approver

IBAN number

International Bank Account Number, consisting of up to 34 alphanumeric characters, is required by banks in

participating countries to confirm the integrity of the bank account number.

Mexico: CLABE Standard Bank Code

An 18 digit identifier for each Mexican bank account.

Australian or New Zealand BSB Number

A six digit numeric code used to identify the bank branch; required along with the SWIFT code for international funds

transfer.