CAF America Request For Wire Transfer

Information
Nonprofit name

As part of our ongoing efforts to support international philanthropy as safely and effectively as possible, CAF
America is now making all grants by wire transfer.

Please complete as thoroughly as possible, print legibly or type.

Please complete ALL applicable fields. Incomplete information can delay grants.

Account Name
Bank Name
Bank Address
(A PO Box is not acceptable)

Account Number / IBAN number
SWIFT Code
Sort Code / Transit Code/IFSC Code
Currency Preferred

Please complete Intermediary Bank information only if an intermediary bank is used.

Intermediary Bank
Intermediary Bank Address
Intermediary Bank ABA / SWIFT
Code
Intermediary Bank Account Number

I confirm that the above information is for an account that solely benefits the above named charity.

I understand that this is my default account, and any grants from CAF America will be directed to this account and
that Iam responsible for providing CAF America with any changes to the charity account.

I understand that all grants made by CAF America into this account are subject to the terms of the CAF America
Grant Agreement.

SIGNED DATED PRINT NAME & TITLE

If you provided an electronic signature, please check the box below.

I certify that by typing my name on the signature line I intend to sign the Agreement and be bound to the same extent as if I had provided a physical signature.

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