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CONFIDENTIAL

Montefiore Nadine Vatau Montefiore


Senior Accountant Office of Development
Medical Center Office of Development 3325 Bainbridge Avenue
Wiring Instructions Bronx, New York 10467
718.920.6656 / nvatau@montefiore.org

n Instruct your banker / broker Account # 483065991933 Bank Contact: Janette Llorens
to execute the transfer to: EIN # 13-1740114 866.222.1948, extension 1987
j.llorens.svc@bofa.com
Montefiore Medical Center - Routing (Domestic wire) # 026009593
Development Cash Donations - Routing (ACH / EFT) # 021000322
Subaccount
Bank of America, N.A. Swift Code International Wires: BOFAUS3N
100 West 33rd Street *US Dollar amount or local currency amount
New York, NY 10001

Todays date: MONTH / DAY / YEAR Date sent to Montefiore from donor’s acct: MONTH / DAY / YEAR

Donor name(s):

Address:

City: State: Zip:

Phone: Email:

Amount: $ Purpose of donation:

Additional special instructions:

Please distribute my gift as follows:


% Unrestricted to Montefiore Medical Center

% Restricted to the following:

% An endowment for:

Thank you for your support of Montefiore!

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