CCBILL
Copyright © 2003 CCBILL LLC
WIRE TRANSFER INFORMATION

Please ask your banking institution for this information, without the correct information we cannot process your wire. All requests need to be filled out and faxed to 1-480-449-8823. Please do not assume a changed has been made unless you receive an email confirmation.

 

Webmaster or Referrer Account #:                                                       Subaccount #:                       
 

Your Existing Bank Account Information

Account holder's name:                                                                                                                  

Bank name:                                                                                                                                   

Bank City:                                                                                              Bank State:                      

Bank Account #:                                                                                                                            

Bank Routing/ABA (within the U.S.) or Swift Code (outside the U.S.):

                                                                                                    

Country:                                                                        

Intermediary Bank Information

This section is only used for international wires that are routed through a U.S. bank before going to the destination bank. Please contact your bank for further details.

Account holder's name:                                                                                                                  

Bank name:                                                                                                                                   

Bank City:                                                                                                      Bank State:              

Bank Account #:                                                                                                                            

Bank Routing/ABA:                                                                                                                        

Country:                                                                        

 

Account Holder's Signature:                                                                                                            

Date:                                                 

 

CCBill LLC, 2353 W. University Dr., Building A, Tempe, AZ 85281-7223, USA, Phone: 800.510.2859, Fax: 480.449.8823
August 2003
CCBL-5004-01