FIRST NAME LAST NAME

CITY STATE COUNTRY

Member Signature:______________________________________________________________________ Date submitted:__________________________
Western Union Money Transfer Order
1560 Cable Ranch Road, Ste. 200 I San Antonio, Texas 78245 I 210.673.5610 I 800.227.5328
Please ll out this form completely, print out and sign. Fax completed, signed form with attention to Wire Transfer Services at 210.678.5291. You may also
deliver it in person to any branch, or mail it to Air Force FCU, Attn: Wire Transfer Services, 1560 Cable Ranch Road, Suite 200, San Antonio, TX 78245.
INSTRUCTIONS
SENDERS INFORMATION
TRANSFER AMOUNT/ACCOUNT INFORMATION
FIRST NAME LAST NAME
STREET ADDRESS CITY STATE ZIP
DATE OF BIRTH SOCIAL SECURITY NUMBER
PHONE EMAIL ADDRESS
On this date: ___________________ Debit funds from Account Number: ____________________________ Account Type: __________________________
(You must be an owner of the account) (Primary Savings, Checking, etc.)
In the amount of $_________________ (NOTE: Orders by FAX or Telephone in the amount of $2,500 or more will require a call back. )
RECEIVING PARTYS INFORMATION
NOTE Maximum payout WITHOUT ID is $999.99. If the receiving party does not have a valid photo ID, you may choose one of the following
options (limited to 25 characters/spaces for each eld):
NOTE Transfer fee within the U.S. and U.S. Military installations is $15.00. International transfer fees vary; Please call for a quote. Transfer fees are not refundable.
I agree that my account will be debited for this service. I hereby authorize Air Force FCU to transfer funds as shown above. I understand that the account
shown will be debited for the amount of the transfer plus any applicable fees. I agree to hold the Credit Union harmless if the funds are not received and
credited due to incorrect or incomplete instructions or information submitted on this form. I have read and agree to the Air Force Federal Credit Union
Wire Transfer Agreement. (See page 2)
AGREEMENT AUTHORIZATION
Pay without ID to the person
with this physical description:
Pay without ID, with the correct
answer to this TEST QUESTION:
Receiving party will give
the following answer:
1733.08/12
CREDIT UNION USE ONLY
All CU Personnel: Date/time received: Transaction Processed By Teller #:
Call back # Tlr # Call back # Tlr #
Accounting: Wire Conrmation # ___________________________ Wire Veried By Teller #_____________ Date/Time Sent:______________________________________
1. Member Appeared in Person
ID Checked
ID Number & ST or Type: ___________________
2. Correspondence/FAX Request
Signature Checked/Teller # ___________________
3. Telephone Request
Member Veried
Signature Checked
I hereby request that Air Force Federal Credit Union (the Credit Union) send the amount indicated on the wire transfer request form to the
bank designated. I understand that this wire transfer is irrevocable and that there is a non-refundable fee for each wire transfer. I under-
stand and agree that the sole obligation of the Credit Union is to exercise ordinary care in processing this wire transfer and is released from
responsibility for any inaccuracy, interruption or delay in transmission beyond its control. The Credit Union is authorized to use any means it
may consider suitable for the transmission of funds. In making this request, I further understand and/or agree that:
Air Force Federal Credit Union will perform the following security procedures before making the transfer:
1) Check at least one piece of identication of the person signing the request to ensure that their name is the same as the name on the
identication and/or, 2) when warranted, verify at least one or more items of information known to us from the member records. A call
back verication is required for all requests not made in person and in the amount of $2,500 or more. The Credit Union is under no obliga-
tion to conrm in any other way the identity of the person making the request.
These security procedures are to ensure that the request was properly authorized. I agree to be bound by my request when authorized by
me or if the Credit Union has accepted it in good faith and in compliance with these security procedures. Any action in addition to these
security procedures in an attempt to determine proper authorization will not become part of the security procedures and the Credit Union
will not be held liable for omitting these same actions with respect to any future requests.
Air Force Federal Credit Union sends wire transfers through the Federal Reserve Banks (FRBs) FedWire system. Because of this, the
transfers are subject to the FRBs Regulation J. If I provide the Credit Union with a name and a routing number for a nancial institution to
receive the transfer, I understand that, in the case of error, the routing number controls the transfer. If I give the Credit Union a name and
an account number of the person or entity to receive the transfer, I understand that, in the case of error, the account number controls the
transaction.
The FRB requires receipt of the wire by a certain time. The wire must be received by Air Force Federal Credit Union by 2:30 p.m. Central
Standard Time to ensure same day processing. If the transfer is received after this time, the transaction will not be processed by the FRB
until the next business day.
The wire transfer request can be delayed or not processed if; 1) I do not have sufcient available funds in my account to cover the request,
2) the nancial institution to receive the transfer, or through which the transfer is to be made, is not acceptable to the Federal Reserve
System, an intermediary institution or the Credit Union, 3) the transfer would cause the Credit Union to violate a law, court order, regulation
or a government guideline or program. If the transfer cannot be made or is signicantly delayed, the Credit Union will attempt to notify me
by telephone.
At the time the wire transfer request is accepted by us, your account will be debited for the amount of the transfer and for the transfer fee.
Please refer to the Truth in Savings Service Fees brochure.
All inquiries about the wire transfer should be made to the Wire Department at 210.673.5610 or 1.800.227.5328
The Wire Transfer Request will be conrmed on my statement of account. If I learn of any error in the transfer, I will notify the Credit Union
immediately in writing to Air Force Federal Credit Union, ATTN: Wire Department, 1560 Cable Ranch Road, STE 200, San Antonio, Texas
78245 or by telephone at the numbers above. In no case may such notice be made more than 14 days after rst conrmation of the re-
quest. If the request is made in error and Air Force Federal Credit Union suffers a loss because I failed to notify the Credit Union within this
14 day period, I will reimburse the Credit Union for such loss.
Air Force Federal Credit Union will be responsible for making the transfer as provided in this agreement and the only representations and
warranties are in this agreement. The Credit Union cannot be responsible for the errors, actions, or failure to act of any other person or
entity used to make the transfer or to transmit information, such as other nancial institutions, government entities or carriers of communi-
cation. These persons and entities are not agents of Air Force Federal Credit Union.
Air Force Federal Credit Union cannot be held responsible for any liability, loss or delay in making the transfer caused by events beyond
the Credit Unions control, such as res, earthquakes, power surges or failures, communication failures, wars, riots, acts of government,
legal constraints. The Credit Union will not be liable to me or my agent for any special, consequential, indirect or punitive damages even if
a claim is based on tort or contract or it was known that these types of damages were likely. If it is determined that the Credit Union was
liable, the Credit Union will provide interest on the funds based on the Share Account dividend rate in effect at the time for the period of
the delay.
This agreement is the entire agreement between us concerning the wire transfer request. If a provision of the agreement is not enforceable,
the other provisions will still be enforceable.
AIR FORCE FEDERAL CREDIT UNION WIRE TRANSFER AGREEMENT
page 2