MD 2100, P.O. Box 619001 DFW Airport, Texas 75261-9001 (800) 533-0035 www.AACreditUnion.

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WIRE TRANSFER REQUEST

Please PRINT legibly when completing this form. Unreadable wire transfer requests will not be processed. A $20.00 fee for domestic wires and a $35.00 fee for international wires will be charged. Account Number: First/Last Name: Address, City, State and Zip:
(Post Office Box not acceptable on entire form)
FOR CREDIT UNION USE ONLY

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Available Balance: Employee Initials Signature verified Journal complete Input complete Released Date processed

Daytime Phone Number: Reason for Transfer: Amount of Transfer: Written Amount: Member or Authorized Signature: Date Signed:

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All wire transactions will be conducted in U.S. Funds.

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FOR BRANCH UNION USE ONLY Mbr Govt Issued Photo ID #

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(MM/DD/YYYY)

Verified by

I agree to be bound by the rules governing automated transfers and acknowledge that entries may not be initiated that violate the laws of the United States. Note: Any missing, incomplete, or inaccurate information listed on this form may result in the non-transfer of funds. Please review carefully.

Supervisors Approval

COMPLETE ONLY ONE OF THE FOLLOWING SECTIONS 1. DIRECT TRANSFERS TO A U.S. BANK:
All information in the section below is required to send a wire transfer.
Routing & Transit / ABA Number Recipients Name Recipients Address (Must include Street Address, City, State, Zip) Bank Name & Phone Number Recipients Account Number (at Bank)

2. TRANSFERS TO FINANCIAL INSTITUTIONS USING CORRESPONDENT BANKS:

(e.g Investment, Loan Payment, Title Company, or Foreign Bank) All information in the section below is required to send a wire. U.S. Correspondent Bank ABA #: U.S. Correspondent Bank Name: For further credit to: Receiving Bank or Account Name: Receiving Partys Account # with correspondent bank (if applicable): Or Receiving Banks Swift or BIC Code # (mostly letters): For final credit to: Recipients Name: Recipients Address (Must include Street Address, City, State, Zip, Country): Receiving Partys Account # at receiving financial institution:

A Credit Union wire representative will call you after they receive your wire transfer form. Please provide your valid phone number where we can call you. FAX the completed form to: (866) 271-2498 ATTN: AA Credit Union Wire Dept.
If you send a wire transfer, Fedwire may be used. Regulation J is the law covering all Fedwire transactions. If you give American Airlines Federal Credit Union (AA Credit Union) a payment order which identifies the recipient of the funds, by both name and account number, payment may be made by the recipients bank on the basis of the bank account number, even if the number identifies a person different than the named recipient. If you give AA Credit Union a payment order which identifies an intermediary or recipients bank by both name and identifying number, a receiving bank may rely on the number as the proper identification even if it identifies a different bank. The Credit Union is not responsible for any liability incurred as a result of non-transfer of funds. AA Credit Union is a registered trademark of American Airlines, Inc. Federally insured by the NCUA

Revised 3/2012