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Form Name:


Used for:

  • Bank-to-bank transfer of funds - domestic and international

  • Payments made using a foreign bank draft.

Required Fields:

Today's Date: Format mmddyy.
Date Payment Reqd: Allow 3-5 days for processing.
Originating Dept: Brown department requesting payment.
Bank Name & Address: Receiving bank information, include street address, country and bank ABA number.

Payee Name & Address:

Name of party ultimately receiving

Payee Acct No.:

Account number of payee at the receiving bank.
Transfer Amount: Amount stated in currency requested by payee. Indicate currency.
Payee's Name: Name of party receiving payment.
Amount of draft: Amount stated in foreign currency.Indicate currency.
Dept Acct numbers FRS 6-digit account(s) and 4-digit subcode(s) to be charged.
Special Instructions Information to help in identifying transaction at the receiving end, i.e. account numbers, order no. etc..

Documents to Attach:

Original invoice or documentation explaining payment request.

Where to Send:

After proper departmental signature is obtained, send two copies of the form with the original documentation to Accounts Payable. This office will forward to ORA or Purchasing for approval, as necessary.

How to Obtain:

Form is available in the Controller's Office.

download available

Special Notes:

Bank requires street addresses (not Box numbers) for sender and all recipients. Absence could delay transfer request.