Fill - Free fillable Domestic Wire Transfer Request Form PDF form

Dear Accountholder,

Before you request a Wire Transfer, please note the following:

• You should make your request 2-3 business days in advance of when you would like us to process your Wire

Transfer to ensure pre-processing and verication can be complete.

• This form cannot be used for outgoing Wire Transfers from an IRA account. For IRA Wire Transfers, call

1-888-204-8966 for special instructions.

• You may submit a Wire Transfer instruction electronically through the Account Center rather than completing

this paper form.

–To submit a Wire Transfer instruction online: log in, click “Transfer,” select “Wire Transfer” and follow the instructions.

– To submit a Wire Transfer instruction through the Discover Mobile App: log in, tap “Transfer Money,” tap “Wire Transfer”

and follow the instructions.

Service Charges: There is a $30 service charge for each outgoing Wire Transfer. The charge will be deducted from your

account balance; do not include it in the Wire Transfer amount.

To request an outgoing Wire Transfer, please follow the steps below:

DOMESTIC WIRE TRANSFER REQUEST FORM

PAGE 1

1. Complete and return both pages 3 and 4 of the Wire Transfer Authorization form to us. The following are your options for

returning the completed form:

• Upload form online: Log in to the Account Center and click on the “Help” tab, then select “Secure Document

Upload” and follow the instructions.

• Fax to: 1-224-813-5213, Attn: Wire Transfer Request

• Mail to: Discover Bank, PO Box 30417, Salt Lake City, UT 84130

2. Call 1-888-728-3136. We must have your verbal authorization before processing your Wire Transfer Request. If you have

already provided verbal authorization, please disregard.

3. Standby for verication. A Wire Transfer Specialist will verify your form before the Wire Transfer is processed. If additional

information is required, a Wire Transfer Specialist will attempt to contact you within 24 hours of your submission at the phone

number of record on your account. Wire Transfer Specialists are available to assist you Monday–Friday, 8 a.m. – 7 p.m. ET

(closed weekends and Federal Reserve Bank holidays).

4. Processing timeline:

• Requests received and veried before 3 p.m. ET on a business day will be processed the same day.

• Requests received and veried after 3 p.m. ET on a business day or any time on a non-business day will be

processed by the next business day.

If you’re Account Center registered, you’ll receive a Secure Message with your Wire Transfer tracking number on the day

your Wire Transfer is sent. You may also call us after 6 p.m. ET on the day your Wire Transfer is sent for your Wire Transfer

tracking number.

For all other questions, call us any time at 1-800-347-7000 (TDD 1-800-347-7454). Our 100% U.S.-based customer ser-

vice team is available 24 hours a day, 7 days a week.

1. FILL OUT FORM 2. CALL 3. VERIFY 4. PROCESS

Your Steps Our Steps

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• When lling out the Originator (Sender) Information, please use your name as it is listed on your account and include your full

Discover Bank account number.

• When lling out the Wire Transfer details, do not include the Wire Transfer Service Charge in the Wire Transfer amount. The

service charge will be deducted from your account balance.

• When lling out Beneciary (Receiver) Information, please enter the name and physical address of the individual or entity you

are sending this Wire Transfer to.

• Please ensure the Beneciary (Receiver) has contacted their Beneciary Bank to:

– Verify the ABA Wire Routing Number is correct for incoming Wire Transfers

– Conrm that the bank name provided matches the ABA Wire Routing Number

• Depending on the reason you are sending this Wire Transfer, you may be required to include additional details in the

“Final Beneciary Information” section, such as:

– Escrow number

– File number

– Loan number

• Make sure to include your printed Accountholder Name and your Accountholder Signature.

• For us to process your wire transfer, you must complete and return both pages 3 and 4.

DOMESTIC WIRE TRANSFER GLOSSARY & TIPS

PAGE 2

Glossary of Terms:

Wire Transfer Tips:

• Originator (Sender): Discover

customer who is sending the Wire Transfer

• Beneciary: Individual or entity that is receiving the Wire Transfer (not the receiving bank)

• Beneciary Bank: Bank where the individual or entity receiving the Wire Transfer holds an account

• Beneciary’s Bank Account Number: The account number at the Beneciary’s bank

• Beneciary Bank ABA Wire Routing Number: This is the nine-digit number assigned in the United States for the purposes

of Wire Transfers

• Final Beneciary Information: This is used when additional instructions are required to send the Wire Transfer. For example,

a Wire Transfer may be credited by the beneciary to another person (such as a title company that receives the wired funds

and credits them to a seller) or there may be a third, intermediary bank in the process that sends your Wire Transfer to its

nal destination.

rev. 0519

All elds are required unless otherwise noted. Both pages of form are required. Type or print neatly. Illegible forms (dark background, unclear writing, etc.) will not be

accepted. After submitting the form, please call 1-888-728-3136 to give a Wire Transfer Specialist your verbal authorization.

NOTE: Wire Transfers received and veried before 3 p.m. ET on a business day are processed on the same business

day. Wire Transfers received and veried after 3 p.m. ET or any time on a non-business day are processed on the next

business day.

This may NOT be the routing number found on checks—conrm

correct number with the bank entered in (5).

First Last

MM / DD / YYYY

5. Bank Name (Bank name only, you can provide any additional details in Section E) 6. ABA Wire Routing Number (for Wire Transfers)

8. Beneciary Name

9. Street Address (NO P.O. Box)

City State Zip/Postal Code

7. Beneciary’s Account Number

3. Wire Transfer Amount (do not include Wire Transfer Service Charge)

4. Date Wire Transfer to be Sent (Funds will not be sent until this date)

U.S. Dollar Amount

First Name (or Name of Business) Last Name

Section A. Your Discover Bank Information

Section B. Wire Transfer Details—Amount you want to send

Section C. Beneciary Bank Information—The bank where the Beneciary has their account

Section D. Beneciary Information—Individual or entity that is receiving the Wire Transfer (not the receiving Bank)

DOMESTIC WIRE TRANSFER AUTHORIZATION FORM

Full account balance, less non-refundable $30 service charge

PLEASE NOTE: Transferring the full Account balance will

close this account.

Return via Secure Document Upload, or mail to: Discover Bank, PO Box 30417,

Salt Lake City, UT 84130, or fax to: 1-224-813-5213, Attn: Wire Transfer Request

PAGE 3

1. Originator (Sender) Name 2. Discover Bank Account Number (No dashes)

10.

For further credit/additional information, including purpose of wire/nal beneciary/escrow title (include physical address for any recipients you list below),

information limited to 90 characters, including spaces:

Section E. Final Beneciary Information (OPTIONAL)

continued on next page

rev. 0519

MM / DD / YYYY

14. Accountholder Name (Please print) 15. Accountholder Signature (Print out form and sign) 16. Date

I certify that the information provided on this form is true and accurate and I authorize this transaction. I understand that Discover Bank will act only on this

request upon receiving my oral conrmation of these instructions. In the event that the information provided is incomplete or incorrect, I release Discover

Bank from any liability that may result. I authorize Discover Bank to transfer funds described above and debit my account in the amount transferred, plus the

outgoing Wire Transfer Service Charge. I understand that if I am transferring the full balance, Discover Bank will close my account. I acknowledge that

Discover Bank does not control how long it will take for the funds to be credited to the receiving account after a Wire Transfer is sent.

Section G. Authorization (Signature Required)

DOMESTIC WIRE TRANSFER AUTHORIZATION FORM

Return via Secure Document Upload, or mail to: Discover Bank, PO Box 30417,

Salt Lake City, UT 84130, or fax to: 1-224-813-5213, Attn: Wire Transfer Request

PAGE 4

11.

What is the purpose of this wire transfer?

Real Estate closing (e.g., purchase or sale of residence / vacation / residential rental property)

Expense payment (e.g., college tuition, car purchase, etc.)

Investment (e.g. transfer of assets to or from another nancial institution for personal, household or family investment purposes)

Transfer/gift to family member/friend

Transfer to my business account

Prefer not to answer

12.

How many wire transfers do you plan on making in the future?

1-5

6-10

11-15

More than 15

13.

What type of wire transfers will you send in the future?

Domestic

International

•

To what foreign countries?

Zero, as indicated above in 12

Section F. Additional Information

All elds are required unless otherwise noted. Both pages of form are required. Type or print neatly. Illegible forms (dark background, unclear writing, etc.) will not be

accepted. After submitting the form, please call 1-888-728-3136 to give a Wire Transfer Specialist your verbal authorization.

Please Note: Pages 3 and 4 of this form must both be returned together for your wire transfer request to be processed.

rev. 0519

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