ACCOUNT ASSET TRANSFER
AUTHORIZATION (INTERNAL)

This document authorizes an internal transfer of a specified account balance and related account assets from the Transferor (current account holder) to the Transferee (receiving account holder) within the same institution. Please print and complete in ink. Attach required identification documents.

Document Reference

WCU-2023-AH-892

Date Generated

October 26, 2023

person Section 1: Transferor (Current Account Holder)

Full Legal Name

Date of Birth

Government ID Type

Government ID Number

Copy of government-issued photo ID attached (required)

Residential Address

Phone Number

Member / Customer Number

Branch / Transit (if applicable)

Account Type (check one)

Personal Chequing Business Account Other (specify)

Account Number

Account Name / Legal Account Title

Effective / As-of Date & Time

paid Section 2: Transfer Details (Completed by Transferor)

Current Total Account Balance (as of date/time above)

Total Assets to be Transferred

Currency

Transfer Instruction / Reference (optional)

Included Items (check all that apply)

Cash balance / available funds Account statements / history (as permitted) Cheques / cheque access (if applicable) Debit card access (if applicable / subject to approval) Pre-authorized debits / bill payments (if supported) Other (describe below)

Asset / Item Schedule (if applicable)

Asset / Item Description	Reference / Identifier	Amount / Value

Additional Instructions / Other Important Banking Information

person_add Section 3: Transferee (Receiving Account Holder)

Full Legal Name

Date of Birth

Government ID Type

Government ID Number

Copy of government-issued photo ID attached (required)

Residential Address

Phone Number

Member / Customer Number

Branch / Transit (if applicable)

Account Type (check one)

Personal Chequing Business Account Other (specify)

Receiving Account Number

Receiving Account Name / Legal Account Title

Section 5A: Transferor Signature

Signature

Date

Printed Name

Date

Section 5B: Transferee Signature

Signature

Date

Printed Name

Date

Section 5C: Witness / Staff (Optional)

Witness / Staff Name

Employee ID (if staff)

Signature

Date

Westman Credit Union