RCUH Policies and Procedures
Last Modified: 04/2020WIRE 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 1
Foreign Wire 2
Currency Type 3
(Select a currency)
CNY-Chinese Yuan Renminbi
HKD-Hong Kong Dollar
NZD-New Zealand Dollar
GBP-British Pound Sterling
KRW-South Korean Won
$ U.S. Dollar Equivalent*
*Enter a USD Equivalent amount only if the vendor has invoiced in USD but agrees to accept a wire payment in a foreign currency type listed above. The exact amount of foreign currency will be calculated using the exchange rate on the date of the wire payment.
U.S. Correspondent Bank Name 4
U.S. Correspondent Bank ABA No. 5
Beneficiary/Vendor Bank Account Name 6
Beneficiary Bank Account Number 7
City and Country
Bank SWIFT Code 8
Remittance/Reference Information 9
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
Charge the Bank Fee(s) to:
A confirmation email will be sent to the Fiscal Administrator on the date of the wire transfer.
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 funds only in the currency types listed.
4 Only applicable to Foreign Wires in U.S. Dollar currency. U.S. correspondent (intermediary) bank information is 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) is a nine‐digit code that identifies banking institutions in the U.S.
6 The name listed should be an exact match to the name on the beneficiary (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 for European 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. SWIFT or SWIFTBIC code is an international 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 this information 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 after the wire transfer date.