WIRE REQUEST FORM: SEND DOLLARS FROM YOUR U.S. ACCOUNT TO AN ISRAELI BANK

INSTRUCTIONS: After you complete this form, a final version of your wire request will be emailed to you.
Print that email and have all account owners sign it.
Scan and email the signed form to operations@profile-financial.com (or fax to 02-624-2789).
Call the Profile office to confirm that we have received your request, 02-624-2788.

What email address should we send the form to now? *

Please enter your account name exactly as it appears on your monthly statement. *

Enter your account number here. *

Enter the phone number(s) where we can reach you now in case there is a problem. *

Amount to wire (U.S. dollars) *

All cash in the account minus transfer fees, and close account

Other (enter dollar amount)

Amount in words *

Reason for transfer of funds *

What is your relationship of person
to whom you are sending the gift?

Is the money being sent to an account with the
same name as your account with us? *

Yes. I am sending the money to my own account.

No. I am sending the money to someone else.

(This field only needs to be completed if the money is being sent to someone other than you.) Please enter ALL OF THE FOLLOWING: Address of recipient, date of birth of recipient, occupation of recipient, Passport # & country issued OR National ID # and country issued *

What is the name of the Israeli bank where the money is going? *

Account name: Bank Massad

What is the IBAN # for the receiving account?

What is the name of the account at the Israeli bank? *

What is the BRANCH number of the Israeli bank? *

What is the ACCOUNT number of the account at the Israeli bank? *

Enter any other reference details that may be required
for this money transfer (you may leave this field blank).

* = Input is required