PORT TERMINAL FEDERAL CREDIT
UNION
WIRE TRANSFER REQUEST
NAME_________________________________________________________
ADDRESS______________________________________________________
CITY, STATE,
ZIP_______________________________________________
DAYTIME PHONE #___
__________________________________________
TRANSFER AMOUNT
$______________________________
ACCOUNT
#________________________________________
|
PERSONS INFORMATION MONEY IS BEING
WIRED TO:
|
NAME__________________________________________________________
ADDRESS_______________________________________________________
CITY, STATE,
ZIP_________________________________________________
ACCOUNT
#______________________________________
|
INFORMATION ON BANK THE MONEY IS
BEING WIRED TO:
|
NAME OF FINANCIAL
INSTITUTION______________________________________
ADDRESS______________________________________________________________
CITY, STATE, ZIP________________________________________________________
ABA ROUTING/TRANSIT
#_______________________________________________
SPECIAL
INSTRUCTIONS________________________________________________
You may identify the payee or any
financial institution by name and by account number or ABA routing number.
The Credit Union and other institutions may rely on the account or other
identifying number as the proper identification, even if it identifies a
different party or institution. If the wire transfer is cleared through the
Federal Reserve, the transaction is governed by Regulation J. You
authorize the Credit Union to transfer funds as described herein and debit
your account in the amount transferred, plus a $15.00 wire fee.
X______________________________________________
Signature
Date
WIRING INSTRUCTIONS:
SOUTHWEST
CORPORATE
6801 PARKWOOD BLVD
PLANO, TX 75024
ROUTING # 311990511
Port Terminal FCU
8934
Manchester St.
Suite 215
Houston, Tx 77012
ACCT # 313084412
MEMBER NAME
MEMBER ACCT #