Wire Transfer Request

Tarrant County’s Credit Union

(Originating Financial Institution)

200 Taylor Street, Suite 215  Fort Worth TX 76196  Phone 817-884-1470  Fax 817-870-1360

WIRE TRANSFER REQUEST

TCCU Member Information

*Items required to process the Wire Request; *Items left blank may delay transfer of wired funds.
*Account Number: / *Member Name:
*Date: / *Address:
*Wire Transfer Amount:$
Domestic Wire Fee: $15.00
Total Withdrawal:$ / Call back Verification (choose one):
HomeWorkCell
TCCU policy requires a call back verification to be made to Member’s phone number of record on all faxed Wire Transfer Requests;faxed requests cannot exceed $2000 and funds must be wired to an account also held by the Member at other Financial Institution.

Receiving Institution

*Name of Financial Institution:
City, State, Zip:
*ABA/Routing Number:
Bank to Bank Information:

Further Credit (optional)

Name of Financial Institution:
Address: City, State, Zip:
ABA/Routing Number or Account Number:

Beneficiary Information

*Name:
*Address:
*City, State, Zip:
*Account Number:
Beneficiary Reference Number:
Originator to Beneficiary Information:

I, the undersigned, understand and agree that: Tarrant County’s Credit Union will rely solely on the ABA indentifying number and receiving account number that I have provided in wiring these funds, even if the name of the party or institution does not correspond to the number; Tarrant County’s Credit Union is not responsible for any losses in the event that the identifying number or account number I provided is incorrect, in any respect; I allow Tarrant County’s Credit Union until 3:30 p.m. of the following business day (Mon. - Fri., 9 a.m. – 3:30 p.m.) to transmit my wire transfer; Tarrant County’s Credit Union cannot, in any way, warrant or guarantee a wire transfer of funds to locations outside the United States and I assume all risk when I request such a wire transfer; a cancellation or amendments of this authorization must be issued in writing by Tarrant County’s Credit Union prior to transmittal of the wire transfer. If you send or receive a wire transfer, Fedwire may be used. Regulation J is the law governing all Fedwire transactions. If you give the Credit Union a payment order which identifies the beneficiary (recipient of funds) by both name and identifying or account number, payment may be made by the beneficiary’s bank on the basis of the identifying or account number, even if the number identifies the person different than the named beneficiary. If you give the Credit Union a payment order which identifies an intermediary or beneficiary’s bank by both name and identifying number, a receiving bank may rely on the number as the proper identification even if it identifies a different person than the named bank. I understand that additional fees may be charged by the receiving entity.

AUTHORIZED SIGNATUREDATE

*Domestic wire requests received after 3:30p.m. CST will be processed the next business day*

***For TCCU Use Only***

Date Received: Received by: / Member Present: Yes
DL# State Exp Member DOB
Faxed Request: Call Back Verification
Phone #: Contacted by:
Date Posted to Account: Posted by: / Faxed Request-Verified Signature: Yes Verified by:
Transmitted Date: Transmitted by: / Faxed Request-under $2000:YesMember’s Account at other FI:Yes
Wire Sequence #: TX OFAC Verified: / Tranzact 2nd Verification by: Date: