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Domestic Wire Transfer Request




$
(Domestic Wire Fee: $20)









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IT IS REQUESTED THAT FUNDS BE WIRE TRANSFERRED FROM THE ABOVE ACCOUNT TO THE FOLLOWING BANK/Heartland FCU:















The undersigned authorizes Heartland FCU to initiate the transfer of funds and charge the account as indicated. Heartland FCU is released from all responsibility, obligation and/or costs associated with other bank’s actions, fees, or failure to deliver funds. I hereby accept and understand that any fees, charges or communication levied by correspondent banks with respect to this transaction are the responsibility of either the Remitter, the Beneficiary, or both.

Some wires may require additional authorization. We will contact you in those circumstances.