-2- (Forms Manual Insert-Form RD 1951-66 )

General - You may use the Fedwire Worksheet to provide payment data to the Financial Institution that will transmit your

payment and message to Treasury. It is designed so that your organization can copy and complete the sheet with the

variable information applicable to each different wire payment. The pre-printed data which is bolded is data that is the

same for every FedWire issued.

FIELD TITLE INSTRUCTIONS FOR COMPLETION

Line (1). Date to Process Wire Enter the month; day date; and 4-digit year that the wire will be initiated. To avoid

delinquency, this date must be prior to the FI cutoff on the installment due date.

Box (2). SENDER F.I. DATA Enter the name and address of the borrower’s FI.

Box (3). FUNDS DATA Enter the borrower’s bank account number; name on the account; total amount of the

wire; FI name; and FI routing transit number in the applicable blocks.

Box (4). BENEFICIARY DATA All data is prefilled. Do not enter any information in this box.

Box (5). RECEIVER F.I. DATA All data is prefilled. Do not enter any information in this box.

Box (6). ORIGINATOR TO

BENEFICIARY DATA:

 Originator ID - Field 1 Do not enter data - Prefilled with a “D.”

 Taxpayer ID No. - Field 2 Enter the borrower’s tax identification number.

(Example 12-356789)

 Borrower name and Address - Enter the borrowers name and address. (Each field can contain up to 35 alphanumeric

 Fields 3 - 6 characters.)

 Borrower Ref. No. - Field 1 For electric and telephone loan borrowers enter the last 5 digits of the 6 digit reference

number that is shown on RUS Form 615, “Statement of Interest and Principal Due.”

(Example: Ref. No. on Form 615 is 123456; the enter 23-456.) For other than electric and

telephone borrowers (e.g., community facility, water & environmental, etc.) enter the 15

digit borrower I.D. as shown on Form RD 370-46, “Payment Coupon.”

(Example: 12-012-0123456789)

 Loan Pgm. Amt. - Fields 2 and 3 These fields are optional and allow borrowers to distribute the total amount of the

payment to multiple loan types. To distribute the payment to multiple loan types, in

each line of Fields 2 and/or 3, enter the loan program acronym* and the amount of the

payment to be applied to that loan followed by a forward slash (/). Payments can be

distributed for up to four loan types in Fields 2 and 3. The sum of all loan program

amounts listed in Fields 2 and 3 must equal the FedWire payment shown in Item 3 -

Funds Data section.

Example: In this example the borrower wishes to distribute a $200,000.00 loan payment

to their FFB, RET, and RTB loans.

Field 2 F F B - 100000.00/

R E T - 50000.00/

Field 3 R T B - 50000.00/

INSTRUCTION FOR PREPARATION
*Loan program acronyms: FFB (for Federal Financing Bank loans); RTB (for

Rural Telephone Bank loans); RET (for RUS electric and telephone loans); CTV

(for Cable Television loans); W&E (for water and environmental loans); B&I (for

Business and Industry loans); CP (for Community Facilties laons.)

 Advice Memo - Field 4 The borrower may use this field to provide supplemental application instructions.

This is a “free text” area, but it is limited to 35 characters.

-3- (Forms Manual Insert-Form RD 1951-66 )

(10-28-03) SPECIAL PN.