One Time Wire Transfer - Delete Request Verification
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Debit Information
Wire type: Domestic wire
Account: *2470 - PRESTIGE HEALTH ACCOUNT
Secutiry code: 
Send on date:
Amount: $5000.00
Currency: USD
 
Recipient Information
Bank ID type: ABA
Bank ID: 072400052
Recipient account: (If appropriate enter the IBAN) 109283748383
Bank name: CITIZENS BANK
Bank address 1: SAGINAW
Bank address 2: MI
Bank address 3:
Recipient name: Joe Customer
Recipient address 1: 1234 Businee Park
Recipient address 2: Jacksonville, FL
Recipient address 3:
Additional information for recipient:
 
First Intermediary Information
Bank ID type:  
Bank routing number:  
Intermediary account: (If appropriate enter the IBAN)  
Bank name:  
Bank address 1:  
Bank address 2:  
Bank address 3:  
 
Second Intermediary Information
Bank ID type:  
Bank routing number:  
Intermediary account: (If appropriate enter the IBAN)  
Bank name:  
Bank address 1:  
Bank address 2:  
Bank address 3:  
 
Wire Initiator Information
Wire initiator name: PRESTIGE DESIGN CORPORATION
Wire initiator address 1: 5430 Data Court
Wire initiator address 2: Suite 100
Wire initiator address 3 (optional): Ann Arbor, MI