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Outgoing Wire Transfer Request

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Yung Carlos
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417 views2 pages

Outgoing Wire Transfer Request

Uploaded by

Yung Carlos
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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OUTGOING WIRE TRANSFER REQUEST

NEVER RELY on emails or non-verbal DO NOT FORWARD wire 555 South Flower Street
communications when initiating a instructions to other parties Los Angeles, CA 90071
 request for outgoing wire payment
 without first verbally verifying
without first verbally verifying the the instructions from the Fax completed form to: (800) 575-5503
instructions from the requesting party. sending party. Pacific Time Zone
ALWAYS VERIFY WIRE INSTRUCTIONS, specifically the ABA routing number and account number, by calling the party who is

WIRE FRAUD ALERT


receiving the funds. DO NOT RELY on other parties calling you. DO NOT use the phone number provided in the email containing the
instructions. Use phone numbers you have called before or can otherwise verify. DO NOT send an email to verify as the email address
may be incorrect or the email may be intercepted by the fraudster.
For more information on wire-fraud scams or to report an incident, please refer to the following links:
Federal Bureau of Investigation: http://www.fbi.gov Internet Crime Complaint Center: http://www.ic3.gov

REQUEST DEADLINES Domestic Wires: International Wires


Request received past the deadline will be processed the next business day. 1:30 p.m. (PT) 12:30 p.m. (PT)
TRANSACTION INFORMATION
Date of Transfer (mm/dd/yyyy) Repetitive ID [If applicable (requires pre-authorization)]

AMOUNT OF WIRE TRANSFER


U.S. Dollars For Wire Sent in Foreign Currency Request Wire Principal Protection Service (fee applies)
$ OR Amount Currency Type Rate Source

SENDER INFORMATION
CNB Deposit Account Number Name of Account Other (bank use only)

Address Second Address Line City, State Zip Country

RECEIVING (BENEFICIARY’S) BANK INFORMATION FOR BANK USE ONLY


Bank Name

Bank Address Second Address Line

City, State Zip Country

Routing Information (e.g., ABA Number, SWIFT BIC, Sort Code, Intermediary Bank)

BENEFICIARY INFORMATION
Account (or IBAN) Number Beneficiary Name

Beneficiary Address Beneficiary Second Address Line

City, State Zip Country

Other Beneficiary Information (Optional - used for sending a message to the beneficiary, for
example, invoice numbers, or purpose of payment)
Signature

CLIENT AUTHORIZATION (All wire transfer requests must be signed by an authorized person.)
By signing below as or on behalf of Sender, I certify that this wire transfer is authorized; the information on this form is correct; and, I have
read and agree to the terms and conditions of the International Wire Transfers section of the Account Agreement and Disclosures by which
Sender is bound. I understand that if an incorrect beneficiary (recipient) account number or receiving bank (recipient institution) identifier
has been provided, Sender could lose the wire transfer amount. If this request is for a transfer from a consumer account to a recipient in a
foreign country and submitted to CNB by facsimile or email, CNB will consider this form as an inquiry pending CNB’s final verification by
telephone. I authorize payment of this wire transfer from Sender’s CNB account designated above.
Name Signature Phone Number

( ) –
Name Signature Phone Number

( ) –

City National Bank Member FDIC


ID 03130E (Rev 10/2023) Page 1 of 2 (057)
City National Bank Member FDIC
ID 03130E (Rev 10/2023) Page 2 of 2 (057)

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