Mt.McKinley Bank - Wire Transfer Form

Mt. McKinley Bank Wire Transfer Form "Deposit Customers Only"
To transfer funds please fill out the form below, print it out from your web browser and sign it. Please FAX the completed form to our Downtown office at (907) 456-5982.

Customer Information
Date: //	Time:

Your Name:
Your Address:
Your Account Number: -
Your Mother Maiden Name:
Your Place of Birth:
Your TIN/SSN: --	Day-time Phone: --

Information for the bank receiving the funds
Name of the Bank:
Receiving Bank's ABA Routing Number:
City and State where receiving bank is located:
Secondary Bank (necessary if the receiving bank is not on-line with the Federal Reserve):
	The bank needs to be on-line with the Federal Reserve. If it is not, we need the Bank's Correspondent Bank Name.

Amount Being Transferred:	Fee:
Wire transfers for deposit customers are $15.00 domestic and $35.00 overseas.
Account Number to be credited:	Account Number:
	Name(s) on Account (at receiving bank):
	Customers Address (at receiving bank):
If the Customer does not have an account at the receiving bank:
Beneficiary Name:
Beneficiary Address:
Beneficiary TIN/SSN: --
Customers Signature of Authorization: __________________________________