Fidelity Bank Wire Authorization Form Completed Form Examples and Samples
Browse real-world examples of completed Fidelity Bank Wire Authorization Forms, including domestic and international wire transfers for personal and business accounts. Each sample shows exactly how to fill out every field correctly — from ABA routing numbers and beneficiary details to authorized signatures and wire amounts.
Fidelity Bank Wire Authorization Form Example – Domestic Business Wire Transfer
How this form was filled:
This example shows a completed Fidelity Bank Wire Authorization Form for a domestic business-to-business wire transfer. The sending account is a corporate checking account held by a small marketing firm, and the funds are being wired to a vendor's business account at a different U.S. bank. All required fields are filled in, including the beneficiary's bank routing number, account details, wire amount, and authorized signature.
Information used to fill out the document:
- Sender / Account Holder Name: Apex Marketing Solutions LLC
- Sender Account Number: 7842109365
- Sender Account Type: Business Checking
- Sender Address: 450 Commerce Blvd, Suite 12, Columbus, OH 43215
- Sender Phone Number: (614) 555-0192
- Wire Transfer Type: Domestic
- Wire Amount: $24,500.00
- Transfer Date: 03/14/2026
- Purpose / Memo: Payment for Q1 2026 Media Production Services – Invoice #CPM-2026-0082
- Beneficiary Name: Clearview Media Group Inc.
- Beneficiary Account Number: 3310298476
- Beneficiary Account Type: Business Checking
- Beneficiary Address: 88 Lakeshore Drive, Chicago, IL 60601
- Receiving Bank Name: First National Bank of Chicago
- Receiving Bank ABA Routing Number: 071000013
- Receiving Bank Address: 1 South Dearborn Street, Chicago, IL 60603
- Authorized Signature: Sandra L. Whitmore
- Title of Authorized Signer: Chief Financial Officer
- Date Signed: 03/12/2026
What this filled form sample shows:
- Correctly completed sender account information including account number and business checking account type
- Properly formatted ABA routing number for the receiving bank
- Detailed beneficiary information including name, account number, and address
- Clear and descriptive purpose/memo field referencing the specific invoice number
- Accurate wire amount formatted with dollar sign and decimal notation
- Authorized signature, title, and date from a company officer with signing authority
- Domestic wire transfer type clearly selected, distinguishing it from an international transfer
Form specifications and details:
| Use Case: | Domestic business-to-business wire transfer for vendor invoice payment |
| Transfer Type: | Domestic Wire Transfer |
| Sending Institution: | Fidelity Bank |
| Sending Account Type: | Business Checking |
| Receiving Institution: | First National Bank of Chicago |
| Wire Amount: | $24,500.00 |
| Industry: | Marketing / Media Services |
| Signer Authority: | Chief Financial Officer (CFO) |
| Form Purpose: | One-time domestic wire authorization |
| Routing Number Format: | 9-digit ABA routing number |
Created: February 25, 2026 06:13 AM
