Fidelity Bank Wire Authorization Form Instructions
This form contains 27 fields organized into 10 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Account Owners | ||
| Account Owner Name | Text |
Enter the full name of the primary account owner.
|
| Additional Account Owner Name | Text |
Enter the full name of the additional account owner or authorized individual.
|
| Additional Wire Instructions | ||
| Additional Wire Instruction 1: Further Credit Details | Text |
Provide specific instructions for the further credit of the wire transfer.
|
| Additional Wire Instruction 2: Wire Transfer Details | Text |
Provide any additional details or instructions that need to be included with the wire transfer.
|
| Address of Wire Recipient | ||
| Recipient Address Line 1 | Text |
Enter the primary street address for the wire recipient.
|
| Recipient City | Text |
Enter the city of the wire recipient's address.
|
| Recipient State/Province | Text |
Enter the state or province of the wire recipient's address.
|
| Recipient ZIP/Postal Code | Text |
Enter the ZIP or postal code of the wire recipient's address.
|
| Recipient Country | Text |
Enter the country of the wire recipient's address.
|
| Correspondent (Intermediary) Bank Information | ||
| Correspondent Bank Routing/ABA Number | Text |
Enter the routing or ABA number for the correspondent (intermediary) bank.
|
| Correspondent Bank Name | Text |
Enter the full name of the correspondent (intermediary) bank.
|
| Fidelity Accounts | ||
| First Fidelity Account Number | Text |
Enter the first Fidelity account number for which you want to establish bank wire instructions.
|
| Second Fidelity Account Number | Text |
Enter the second Fidelity account number for which you want to establish bank wire instructions.
|
| Third Fidelity Account Number | Text |
Enter the third Fidelity account number for which you want to establish bank wire instructions.
|
| General | ||
| Button | ||
| Reset | Button | |
| Save | Button | |
| International Recipient Bank Information | ||
| Account is Outside the United States | Checkbox |
Check this box if the recipient bank account is located outside of the United States.
|
| International Recipient Bank SWIFT Code | Text |
Please enter the SWIFT (Society for Worldwide Interbank Financial Telecommunication) code for the international recipient bank.
|
| International Recipient Bank Country | Text |
Please enter the name of the country where the international recipient bank is located.
|
| Page 3 | ||
| First Printed Owner/Authorized Individual Name | Text |
Enter the full printed name of the first owner or authorized individual.
|
| Second Printed Owner/Authorized Individual Name | Text |
Enter the full printed name of the second owner or authorized individual.
|
| W-8-Certified Customer Explanation | ||
| W-8-Certified Customer Explanation Reason | Text |
Provide the reason for requesting standing instructions to send money to a financial institution in a country different from your tax residence.
|
| Wire Recipient Bank and Account Information | ||
| Wire Recipient Bank Routing/ABA Number | Text |
Enter the bank routing or ABA number for the wire recipient's bank.
|
| Wire Recipient Bank Name | Text |
Enter the full name of the wire recipient's bank.
|
| Wire Recipient Account Number | Text |
Enter the account number for the wire recipient.
|
| Wire Recipient Account Owner Name(s) | Text |
Enter the name(s) of the wire recipient account owner(s).
|