Preparation of Electronic Funds Transfer (EFT) Disbursement Payment Request Form
MFA offices must prepare an EFT (Electronic Funds Transfer) Disbursement Payment Request Form when seeking electronic delivery of a payment. No EFT disbursement request will be processed unless the required form is properly completed. Guidelines for completing the EFT Disbursement Payment Request Form appear below. Note that rows 16, 19, and 20 have been formatted to treat numbers as if they were text so a leading zero is not dropped.
| Line # | Line Description | Specific Instruction |
|---|---|---|
| 1 | Date | Date form is prepared. |
| 2 | Preparer’s name | The name of the individual initiating the wire transfer payment. This person cannot be the same as the individual who approves the request on line 11. |
| 3 | Preparer’s phone # | Number we can call with any questions. |
| 4 | Preparer’s email address | Email address we can contact you at with any questions. |
| 5 | Payment due date | Date the money is to be received by payee. |
| 6 | Purchase order # | If a PO exists and is known, please complete this field. Please refer to the MFA's procedures governing purchase orders. In the event funds are to be transmitted in a foreign currency, and purchase order cannot be issued, please attach contractual documents to the EFT form. |
| 7 | Payment explanation | Provide a brief explanation (for internal use) for the EFT request. Be as specific as possible. |
| 8 | Department | The name of the office initiating the request. |
| 9 | Authorizer’s name (not #2) | The name of the person authorizing the payment. |
| 10 | Authorizer’s email address (not #4) | Email address at which we can contact the approver with any questions. |
| 11 | Authorized signature | The signature of the authorizing individual within the department indicating approval of the payment. The general rule is that the person who has budgetary responsibility (or their designee) is the authorized signer. EFTs that will be charged against account strings that include an “E” fund must be countersigned by Accounting and Financial Services. As noted above, the person authorizing the transaction should not be the same as the preparer on line 2. |
| 12 | OVPR signature and stamp | Payments that are being charged to a Sponsored Project must be signed by an authorized individual in the Office of the Vice President of Research. |
| 13 | Payee name | The name exactly as it appears on the bank account. |
| 14 | Payee address | Should include, at a minimum, the city and state where payee lives. For payees outside of the US a complete address is requested. |
| 15 | Other payee information | Additional information that may be required, such as a phone number or Tax ID. See country specific information below for details. |
| 16
16a 16b |
Name on payee bank account
Payee bank account # (US) Payee foreign bank account # or IBAN # (Foreign) |
Name of payee as it appears on the bank account.
US payments – enter the payee’s US bank account number. Foreign payments - For payments, regardless of currency, that are going to a European country, the 24 character International Bank Account Number (IBAN) is required. A helpful IBAN decoder website to determine if you have a correctly formatted IBAN is |
| 17 | Payee bank name | The name of the bank or financial institution. |
| 18 | Payee bank address | The street address, city, and state for the bank. This information will help sending bank’s wire room confirm the exact bank location to which the payment will be delivered. |
| 19
19a |
Payee bank routing number (US)
Payee bank SWIFT code (Foreign) |
From the dropdown box, select the routing type (ACH OR FedWire) for transfers within the US). On the blank line next to the dropdown box, enter the routing information. By way of explanation, all banks have unique identifiers that assist in routing electronic payments to them. Within the US, the routing number is called an ABA number and is 9 digits long. For some banks, the ABA number is different for ACHs and FedWires. For other banks, only one routing number is used.
For international payments the routing information is in the form of a SWIFT code (a combination of digits or letters that are 8 or 11 characters long). A helpful website to verify the SWIFT code is http://www.swiftbic.com. |
| 20 | Other bank information | Branch code, bank code, etc. should be put here. See country specific information below for details. Special requirements for Chili, China, and Mexico are on the dropdown menu and after selecting requirement, indicate information on line underneath. |
| 21 | Remittance message | Include any remittance message that needs to be included in the EFT payment. Examples of remittance messages are “For further credit to XXX,” “Invoice # XXX,” “Rent for January XXX,” etc. Some countries have specific requirements; see country specific information section below. |
| 22 | Payee email address | Email of payee if additional information is needed. |
| 23 | Other email address | Other interested parties that need notification alerting them that the payment has been initiated. |
| 24 | Oracle Alias / Natural Account #, currency, disbursement amount | Use these lines to inform MFA Payables department of the individual account code combinations and the payment amount to be charged to each combination. Also include the currency code and the amount you want transferred. Use as many lines as you need. |
| 25 | Total | Summation of the amounts that appear on line 24. Be sure to include currency code. |
| 26 | Regions | For foreign accounts only, select region from dropdown. |
| 27 | Type of activity (foreign accounts only) | For foreign accounts only, select type of activity from dropdown. |
| 28 | Internal notes | Any other information you wish to include. Comments on this line will not be included in the EFT or email addresses on lines 22 or 23. |
Supporting Documentation
Each EFT form must include an attachment of supporting documentation that has been signed by an authorized signer. The supporting documentation must provide a source document with accurate banking information and must match the EFT form.
Documentation must also include sufficient information to substantiate the amount and currency of the payment as well as the business purpose, the payee’s name, address, and the date and nature of the transaction. Examples of acceptable supporting documentation include an approved invoice or a signed contract. The documentation needs to support the exact amount on line 25. Create a spreadsheet if necessary to show how the support adds to the total on line 25.
Supporting documentation for wires that are processed by Accounting and Financial Services. must include support for the banking instructions. Acceptable examples include wire instructions on the invoice, a Supplier Registration Form, a bank letter with the instructions, or an email from the payee with the instructions.
Documentation for Tax Compliance
Each EFT form will be reviewed by Supplier Maintenance, MFA Payables, and the Tax department for tax compliance and application of tax treaty benefits.
Payments to non-US individuals and organizations are subject to different IRS rules than those to US individuals and organizations. A W-8 series form is required for all payments with the only exception being a valid expense reimbursement supported by receipts (i.e. for travel related expenses). The absence of a properly completed form may subject the non-US individual or organization to federal withholding tax. US-sourced activity may require federal withholding tax even with the form depending on circumstances.
Any questions may be directed to the Tax Department at 571-553-8313.
Additional Instructions
The originating office will email completed copies of the EFT Disbursement Payment Request Form and supporting documentation to MFA Payables at p2p@gwu.edu. It is recommended that the originator retain a copy for their records as well.
Upon receipt of an authorized EFT form and supporting documentation, the MFA Payables department will review the request for appropriate tax documentation; approve in the area reserved for their use and process through the ePayables system; or forward the form and supporting documentation to Accounting and Financial Services. Under certain circumstances Accounting and Financial Services.receives and processes urgent EFT requests and will forward to MFA Payables for booking.
Payments processed by Accounting and Financial Services. will be released via electronic payment from the MFA’s bank account so that the payment is scheduled for delivery to the payee’s bank account on the payment due date (line 5). To allow adequate time for processing, Accounting and Financial Services.should receive the EFT request as least three days before the due date. Confirmation of payment will be visible in Concur Invoice after the payment has been released from the MFA’s bank account.
Country Specific Information
| CCY | Country / Currency | Special Requirements | Additional Requirements |
| ALL | Albanian Lek | Full Beneficiary Bank name and address Full Beneficiary name, address, and account number Reason for payment (taxes, salary, capital injections, etc.) |
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| AMD | Armenian Dram | Full Beneficiary name, address, and account number Reason for payment (taxes, salary, capital injections, etc.) |
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| AOA | Angola Kwanza | Full Beneficiary name, address, and account number Full Remitter name, address, and account,number Reason for payment (taxes, salary, capital injection, etc.) |
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| ARS | Argentinian Peso | Beneficiary full name and address Beneficiary's bank (including branch location) Beneficiary's account number Beneficiary's telephone number Agency Code Remitter's full name and address, account number Reason for payment (taxes, salary,capital injection, etc.) CUIT Tax ID Number |
Please note the beneficiary needs to sign all documents at their bank before ARS is credited to their account. The bank in Argentina will hold payment orders for 90 days, if the beneficiary does not collect the funds on value date. If at 90 days the payment is still pending the banks will then reject the payment. However, the funds will not be returned unless the beneficiary advises their bank to do so. If Beneficiary does not sign for funds on value date, the USD will be converted to ARS at that day’s value. |
| AZN | Azerbaijan Manat | Full Beneficiary name and address Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injections, etc.) |
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| BAM | Bosnia-Herz Marka | Full Beneficiary name and address Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injections, etc.) |
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| BDT | Bangladesh Taka | Full Remitter name, address, and account number Full Beneficiary name, address, and account number Reason for payment (taxes, salary,capital injection, etc.) |
Beneficiary is required to sign documents at their bank in order to receive BDT in their account. |
| BIF | Burundi Franc | Full Beneficiary name and address Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injections, etc.) |
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| BRL | Brazil Rial | Beneficiary's bank (including branch location and agency code) Beneficiary's IBAN (29 Characters in length starting with BR) Beneficiary full name and address Beneficiary's telephone number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) CNPJ Tax ID Number |
Beneficiary must declare local currency and sign for it. Please note the bank in Brazil will hold payment orders for 90 days if the beneficiary does not collect the funds on value date. If at 90 days the payment is still pending the banks will then reject. If Beneficiary does not sign for funds on value date, the USD will be converted to BRL at that day’s value. |
| BTN | Bhutan Ngultrum | Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| BYR | Belorussian Rouble | Beneficiary full name and address Beneficiary's bank (including branch if applicable) Beneficiary's account number (13 digits) Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Bank name and MFO Bank Code - 3 or 9 digits |
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| CLP | Chilean Peso | Beneficiary's bank (including branch if applicable) Beneficiary's account number and account type Beneficiary full name and address Beneficiary telephone number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) RUT Tax ID number |
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| CNY | Chinese Yuan | Beneficiary's bank Beneficiary bank branch location Beneficiary's account number Beneficiary full name and address Beneficiary telephone number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) |
Beneficiary must declare local currency and sign for it. If beneficiary does not sign for funds on value date, the USD will be converted to CNY at that day’s value. |
| COP | Colombian Peso | Beneficiary full name and address Beneficiary's bank Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Tax ID number Beneficiary telephone number Branch Location or Agency |
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| ERN | Eritrean Nakfa | Full Beneficiary name, address, and account number Beneficiary's bank exact location Full Remitter name, address, and account number Reason for payment (taxes, salary,capital injection, etc.) |
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| GEL | Georgia Lari | Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| GTQ | Guatemala Quetzal | Beneficiary full name and address Beneficiary's bank Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Exact branch location NIT Tax ID number |
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| GNF | Guinea Franc | Beneficiary full name and address Beneficiary's bank Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Exact branch location |
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| IDR | Indonesian Rupee | Any IDR purchase of 500 mm or more: Reason of payment or invoice on why IDR is being purchased | |
| KGS | Kyrgyzstan Som |
Full Beneficiary name, address, and account number |
The Beneficiary needs to present identification documents to receive funds. |
| KMF | Comoros Franc | Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| KRW | Korean Won | Beneficiary full name and address Beneficiary's bank Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Beneficiary telephone number |
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| KZT | Kazakhstan Tenge | Beneficiary's bank branch location and BIC Beneficiary full name, address, and account number Beneficiary Tax ID Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) |
The Beneficiary needs to provide appropriate documents in accordance with currency control legislation of republic. |
| LAK | Lao Kip | Beneficiary's bank branch location Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| LBP | Lebanese Pound | Full Beneficiary name, address, and IBAN Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| LTL | Lithuanian Litas | Full Beneficiary name, address, and IBAN Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| LVL | Latvian Lat | Full Beneficiary name, address, and IBAN Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| LYD | Libyan Dinar | Beneficiary's bank branch location Full Beneficiary name, address, and IBAN Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| MDL | Moldavian Leu | Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| MGA | Madagascar Ariary | Beneficiary's bank branch location Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| MKD | Macedonian Dinar | Beneficiary full name and address Beneficiary's bank exact location Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Beneficiary telephone number |
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| MNT | Mongolian Tugrik | Beneficiary full name and address Beneficiary's bank exact location Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Branch location or Agency |
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| MOP | Macao Pataca | Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| MRO | Mauritania Ouguiya | Beneficiary full name and address Beneficiary's bank exact location Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Branch location or Agency |
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| MWK | Malawi | Beneficiary full name and address Beneficiary's bank Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) NIB Bank Identification Number |
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| MVR | Maldives Rufiyaa | Beneficiary's bank exact location Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| MZN | Mozambique Metical | Beneficiary full name and address Beneficiary's bank exact location Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) NIB number |
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| NGN | Nigeria Naira | Beneficiary Bank sort code (9 digits) Beneficiary account number |
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| NPR | Nepal Rupee | Beneficiary full name and address Beneficiary's bank exact location Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) |
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| PEN | Peruvian Sol | Beneficiary's bank branch location Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| PKR | Pakistan Rupee | Beneficiary full name and address Beneficiary's bank Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) Exact branch location with 11 digit BIC code |
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| PYG | Paraguay Guarani | Beneficiary's bank exact location Full Beneficiary name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| RUB | Russian Ruble |
Beneficiary Requirements: Beneficiary Bank Requirements: Additional Required Information: |
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| RWF | Rwanda Franc | Beneficiary full name and address Beneficiary's bank exact location Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) |
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| SCR | Seychelles Rupee | Beneficiary's bank exact location Full Beneficiary name, address, and account number Full Remitter name, address, and account number |
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| SLL | Sierra Leone Leone | Beneficiary full name and address Beneficiary's bank exact location Beneficiary's account number Remitter's full name and address, account number Reason for payment (taxes, salary, capital injection, etc.) |
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| TWD | Taiwan Dollars | Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
The Beneficiary is required to sign documents if payment order is not settled directly with beneficiary bank. Beneficiary's bank sends arrival notice to Beneficiary. Beneficiary must endorse and return to bank. Beneficiary's bank then sends endorsed notice to PNC agent who, upon arrival of document, sends TWD. |
| TZS | Tanzanian Shilling | Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
Beneficiary must provide letter from beneficiary bank stating they can receive hard currency. |
| UAH | Ukrainian Hryvnia | Beneficiary's bank exact location Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| UZS | Uzbekistan Som | Beneficiary's bank exact location Full Beneficiary name, address, and account number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| VEF | Venezuelan Bolivar Fuerte | Full Beneficiary name, address, account number, and account type RIF Number Beneficiary's telephone number Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| VND | Vietnamese Dong | Beneficiary's bank exact location Full Beneficiary name, address, account number, and account type Full Remitter name, address, and account number Reason for payment (taxes, salary, capital injection, etc.) |
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| XPF | Central Pacific Franc | Beneficiary's bank exact location Full Beneficiary name, address, and account number Full Remitter name, address, and account number Nature of operation |
Can only be sent to the following countries: New Caledonia, French Polynesia, Wallis and Futuna Islands |