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Form B Centennial College Student Wire Transfer

Assistant Signature Date:

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PR Sanguir
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382 views1 page

Form B Centennial College Student Wire Transfer

Assistant Signature Date:

Uploaded by

PR Sanguir
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Form B

Please ensure completed forms are CONFIDENTIAL


typed and printed with all the required information.
Handwritten forms will not be accepted.
accepted.
Wire Transfer Request - Student Refund
Please ensure completed forms are type and printed with all required information and signatures.
Hand-written forms will not be accepted.

Date
Student Number Student Name

Student Information Student Email Student Telephone Number

Beneficiary Name

Beneficiary Information
(Required)
Beneficiary Address - Number, Street and Apartment Number or P.O. Box Number
Beneficiary's name and
address must match the
name and address of the
City, Province/State/Region, Postal Code/Zip Code
registered bank
account holder.

Country

Beneficiary Bank Account Number, IBAN or CLABE Bank Code (SWIFTCode - 8 or 11 Characters)

Banking Information Bank Name Bank Account Type (Chequing, Savings, Other)
(Required)

Please Note:
All payments will
Bank Address - Number, Street and Apartment N u m b e r or P.O. Box Number, City, Province/State/Region, Postal Code,
default to the local Country
currency of which
the beneficiary account
is located, unless
Bank Account Currency Bank Identifier (Transit, India IFSC Code, Chin CNAPs, etc)
otherwise agreed upon
by the College.

Other required banking information (e.g. Intermediary Bank Information)

For Financial Services Use Only


Prepared by: Signature: Date:

Approved by: Approved by: Date:

Administrative Fee: Reason: Fund-GL Code:

Transaction Currency: Total Refund:

A/R Manager: A/R Signature Date:

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