Wire Transfer Request

PO Preparer Information

Preparer Campus

UCLA

Preparer University ID

Preparer EmplID (UC Path ID)

Preparer Email

Preparer Phone

Where can I find the ID?

Approver University ID

Approver EmplID (UC Path ID)

Approver Email

Approver Phone

Please enter the authorized wire approver contact information. Approver may receive an email notification from AP regarding this request.

Vendor Details

Vendor Region

AustraliaEuropeMexicoAll Others

Vendor Country (Australia)

Vendor Country (Europe)

Vendor Country (All Others)

Vendor Name

Vendor Email

Address 1

Address 2

City

Postal Code

Pay To - Beneficiary Bank Information (branch where the Vendor's account is located)

Name

Email

Address 1

Address 2

City

Postal Code

Vendor Account Region

AustraliaEuropeMexicoAll Others

Vendor Account Country (Australia)

Vendor Account Country (Europe)

Vendor Account Country (All Others)

Account Number

BSB Number

IBAN

CLABE

18 digits required.

Bank SWIFT Code

Routing Number

9 digits required.

Does the Vendor have an Intermediary Bank?

YesNo

Intermediary Bank Details

Name

Email

Address 1

Address 2

City

Postal Code

Intermediary Bank Region

AustraliaEuropeMexicoAll Others

Intermediary Bank Country (Australia)

Intermediary Bank Country (Europe)

Intermediary Bank Country (All Others)

Account Number

BSB Number

IBAN

CLABE

18 digits required.

Bank SWIFT Code

Payment Details

Fund Currency

Is this a Corporation?

YesNo

Contact Name

Contact Phone

Ext

WT Amount

PO Number(s)

Please separate purchase order #'s by comma.

Loc

Account

CC

Fund

Project

Source

Sub

Obj

Purpose of Wire

List of Documents

Invoice/ReceiptsCurrency ConversionE-mail with Payee Bank InformationOther

Attachment

PDF, Word or Excel are the only allowable documents

Contact Information