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Wire Transfer Request Form

* Required Fields

Date:

/ /

Your Information

First Name:

Last Name:

Member Number:

Source of funds account type:

Or Other Account Type:

Address:

City:

State:

ZIP:

Email Address:

Amount of Wire:

Recipient Information

Name of Receiving Bank:

Receiving Bank Address:

City:

State:

ZIP:

Routing or ABA Number:

Further Credit (or 2nd bank name):

Account number (or 2nd bank ABA):

Receiver (Beneficiary) Name:

Receiver (Beneficiary) Address:

City:

State:

ZIP:

Reason for Wire:

Receiver account number:

Type of Account:

Other Instructions:

Source of funds:

Relationship to Beneficiary:

I hereby request that Ohio University Credit Union initiate the above wire transfer. I realize that requested wire transfers, which are received by OUCU later than 4:00pm will be completed the following day.

A credit union representative will be contacting you soon to confirm the details of the wire.

For security purposes, we may request additional information to complete the transaction.

*Fee will be debited along with the wire amount. Domestic wire fee (if there is a 9-digit routing number) is $15. Due to new regulations, we do not offer international wire service.

Certain restrictions apply.

Security Code:

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Wire Transfer Request Form