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Funds Transfer Request Form May 2019

Raul Torres Rabago is requesting a wire transfer of $71,133.38 USD from his account at Terrabank N.A. to Audi Stuart/Mar Horch at JP Morgan Chase N.A. to purchase an Audi Q7 car. The funds will be sent from Terrabank through intermediary bank Terrabank to beneficiary bank JP Morgan Chase, where Audi Stuart/Mar Horch's account is located. Raul Torres Rabago authorized the transfer by signing the funds transfer request form.

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1918 Hotel Tropicana
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77 views

Funds Transfer Request Form May 2019

Raul Torres Rabago is requesting a wire transfer of $71,133.38 USD from his account at Terrabank N.A. to Audi Stuart/Mar Horch at JP Morgan Chase N.A. to purchase an Audi Q7 car. The funds will be sent from Terrabank through intermediary bank Terrabank to beneficiary bank JP Morgan Chase, where Audi Stuart/Mar Horch's account is located. Raul Torres Rabago authorized the transfer by signing the funds transfer request form.

Uploaded by

1918 Hotel Tropicana
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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FUNDS TRANSFER REQUEST FORM

Date of Transfer: 27 JUNE 2022 Type of Currency: USD


(Fecha de Transferencia): (Tipo de Moneda):

Amount of Transfer: (Monto de Transferencia): In Numbers / (En Números): 71,133.38


Written / (En Letras): SEVENTY-ONE THOUSAND ONE HUNDRED AND THIRTY-THREE DOLLARS AND 38/100

Purpose of Payment / (Propósito de Transferen- Buying Audi Q7 car


cia):
TYPE OF TRANSFER / Tipo de Transferencia
Domestic Wire (US) / International Wire / Foreign Currency Wire / Internal Transfer / ProTransfer
Transferencia Domestica (US) Transferencia Internacional Transferencia en moneda Extranjera Transferencia Interna

ORIGINATOR / (Originador) BENEFICIARY / (Beneficiario)


Name / Nombre: RAUL TORRES RABAGO Name / Nombre: AUDI STUART / MAR HORCH
Account Number / Número de Cuenta: 1301064606 Account Number / Número de Cuenta: 508755969
Address (No PO Box) / 1111 SE WESTCHESTER DR, PORT ST LU- Address (No PO Box) / 100 East Broad St 11 th Floor
Dirección – No PO Box: CIE, FL 34952 Dirección – No PO Box:
Columbus, Ohio 43215

INTERMEDIARY BANK (IBK) / Banco Intermediario BENEFICIARY BANK (BBK) / Banco Beneficiario
Bank Name / Nombre del Banco: TERRABANK, N.A. Bank Name / Nombre del Banco: JP Morgan Chase N.A.
ABA / SWIFT / ACCT# 066012333 / TBNAUS33 ABA / SWIFT / ACCT# CHASUS33XXX
Bank Address (No PO Box) / 3191 CORAL WAY MIAMI FL 33145 Bank Address (No PO Box) / 43215
Dirección – No PO Box: Dirección – No PO Box:

REFERENCE / Referencia:      

CUSTOMER AUTHORIZATION / Autorización del cliente:


CUSTOMER NAME: RAUL TORRES RABAGO

CUSTOMER SIGNATURE: DATE: JUNE 27, 2022

FOR BANK USE ONLY / Para uso interno del Banco: LOAN DISBURSEMENT:
REQUEST RECEIVED BY E-MAIL/FAX: REQUEST RECEIVED IN PERSON:
Name of Authorized Contact Person:       ID #          
Phone # Contacted:       PERSONALLY KNOWN - BY (Initials):
Date Contacted:       Signature Verified: Yes - BY (Initials):
Time of Contact:       Form Reviewed By (signature):
Funds Transfer Agreement on File: Yes No
Signature of Officer’s Approval:
Signature Verified: Yes - By (Initials):
Operations Officer Approval:

SECURITY QUESTIONS
1.       4.      
2.       5.      
3.       6.      

Loan Stamp Area:

FUND TRANSFER REQUEST FORM Rev. 5/2019

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