Company Wire Request Form


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									This template can be used when an individual or entity wants to wire transfer money
from one bank account to another. This template includes the name of the payee, the
payee’s bank name, the payee’s bank address, the bank account number, the amount,
the purpose of the wire, the wire originator, and who the wire was approved by. This
template should be used by individuals or entities who want to wire transfer funds from
one account to another.
                          Company Wire Request Form

Payee: _____________________________________

Payee Bank Name: ______________________________________

Payee Bank Address: ____________________________________


Bank ABA/SWIFT: ______________________________________

Bank Account: __________________________________________

Amount: ______________________ USD: ________________________

Purpose of Wire: ______________________________________________

Cost Center: __________________________________________________

Account Number: _____________________________________________

AFE Number (If applicable): ______________________________________

Wire Originator: _____________________________     Date: ____________________

Wire Approved By: ___________________________      Date: ____________________

Wire Initiated By: _____________________________   Date: ____________________

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