International Bank Account Information Form

Emergency Assistance Foundation, Inc.

Emergency Assistance Foundation, Inc. has partnered with Convera to issue grant payments via international wire to your bank account. If you do not have a bank account, please consider submitting a Cash Pickup Form. A new window will open.

REFUGEES: Please enter your current location in the Contact Details Secion below.

If questions arise while completing the form, please review Frequently Asked Questions (FAQ) and work directly with your bank to ensure all required fields are accurate. You may also contact the Convera Global Pay Customer Service center via VendorManagement@convera.com

IMPORTANT NOTE : You will receive a confirmation email once a payment has been made to the bank account you have provided. Please note that entering incorrect account information may result in a delay or loss of funds. Emergency Assistance Foundation, Inc. and Convera claim no liability for any payments submitted using erroneous account information entered by the user.

Payment ID

Your Payment ID is included in the email notification you received.

Bank Country

Select the country in which your bank branch is located.

Name of Bank Account Holder

Enter name of bank account holder. Name must exactly match the name on the bank account. Please contact your bank if unsure.

Bank Name

Enter name of your bank. Please contact your bank if unsure.

Account Number

Enter Account number. Please contact your bank if unsure.

IBAN

Enter your IBAN. If this number is entered incorrectly, we will be unable to make payment. Please contact your bank if unsure.

Routing Code

The Clearing Code will be 6 digits in length containing the 3 digit Bank code and the 3 digit Branch Code. Important: The last 3 or Branch Code much mast the first 3 digits of your Bank account.

ACH/ABA/RTN

Enter 9 digit ACH/ABA/RTN Code. Please contact your bank if unsure.

IFSC Code

Enter IFSC code - visit Bank IFSC Code website, if not available enter Routing Code. Please contact your bank if unsure

BSB code

Enter 6 digit BSB Code. Please contact your bank if unsure.

Bank Code

Enter Bank Code. Please contact your bank if unsure.

Transit Number

Enter 4 digit Institution Identifier followed by 5 digit Branch Identifier. Please contact your bank if unsure.

Bank SWIFT Code or BIC

Enter your bank swift code. Search for your bank by visiting The Swift Codes

BIK

SKN code

Enter SKN. Please contact your bank if unsure

Individualniy Nomer Nalogoplatelshchika

Enter Individualniy Nomer Nalogoplatelshchika.

CNAPS

Enter CNAPS. Please contact your bank if unsure.

Tax Id

Enter Tax Id.

National ID Number

Enter National ID Number.

Registro Unico Tributario Number

Enter 9 digit Registro Unico Tributario Number.

Cedula De Ciudadania Number

Enter Cedula De Ciudadania Number.

Cedula Juridicia

Enter Cedula Juridicia.

Bank Address

Enter street address of bank branch. Please contact your bank if unsure.

Bank City

Enter City of bank branch. Please contact your bank if unsure.

State / Province

Select State/Province of your bank branch. Please contact your bank if unsure.

Bank Postal Code

Enter zip/postal code of your bank branch. Please contact your bank if unsure.

Contact Details

Please provide your contact details below.

Country

Select Country of residence.

Legal First Name

Enter First Name.

Legal Last Name

Enter Last Name.

Date of Birth

For identification purposes, please provide your date of birth.

Please provide your Email.

Re-enter email address

Address

Enter Full street address of residence.

City

Enter City of residence.

State / Province

Enter state/province of residence.

Postal Code

Enter zip/postal code of residence.

Telephone

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