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Printable Western Union Form in PDF

The Western Union form is a document used for sending and receiving money through Western Union's services. This form is essential for initiating transactions, whether for personal or business purposes. Understanding its components and requirements is crucial for ensuring smooth and efficient money transfers.

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1800 501 500

*1235 Send Money

*1236 Receive Money

CUSTOMER NAME

PLEASE PRINT CLEARLY. Identification is required for all customers: Current Passport, Australian Drivers Licence or Proof of Age Card.

Full Legal	First	Middle	Last
Name

EXISTING CUSTOMERS

NEW CUSTOMERS

or updated details for existing customers

Mobile Number

Western Union Customer Number

Address (Post office box addresses are not permitted)

Suburb

State

Postcode

Country of Citizenship (must have)

Mobile Number

Date of Birth (DD/MM/YYYY)

Country of Birth (must have)

To send money, complete this section

TRANSACTION DETAILS

OPTIONAL

SERVICES FOR SENDING

Destination Country

Destination Currency		Amount to be Sent.	Australian Dollars	$		or	Payout Amount at Destination
		Complete one only.	(AUD)	$		or

	I want the money sent
	I want the money sent	Bank Name			Bank Code / BIC
	direct to a Bank Account
	direct to a Bank Account

Account Name		Bank Location (City)			Account Number / IBAN

I want the money sent to a mobile

Country Code

Mobile Number

RECEIVER’S	Western Union wants to help you avoid being exposed to fraud. If you don’t know the person you’re sending to, we recommend you do not send.
DETAILS	Neither Western Union nor its Agents carry out a comparison of the “To Send Money” form against the “To Receive Money” form to verify the address given for the receiver.
	Full Legal	First	Middle	Last

	Name

	Current Address		(Post office box addresses are not permitted)

City / Suburb

State / Province

Postcode

Country

TEST QUESTION

Not required for all countries. If unsure if this is required, ask at the counter for further details.

Question

Answer

To receive money, complete this section

All fields must be completed

Money Transfer Control Number

Amount Expected

Originating Country

(AUD)

Sender’s

First

Middle

Last

Name

CUSTOMER’S SIGNATURE

All customers to complete this section

The exchange rate for your transfer appears on the Transaction Receipt. However, if the country to which you are sending requires that transfers be converted when paid, the rate shown is only an estimate. Western Union and its Agents also make money from currency exchange. The terms and conditions governing this money transfer are available at this Agent location, can be viewed at westernunion.com.au, and have been summarised on the back of th is form for reference only. You agree to those terms and conditions by signing this form.

By signing this form, you: 1. Expressly consent to the transfer of your personal data entered above to WU Affiliates located ou tside of the European Economic Area, including to the U.S. for the purpose of providing the money transfer service to you and undertaking the additional data processing activities specified in the Data Protection section of the terms and conditions. You have the right to withdraw your consent at any time. 2. Expressly consent to the carrying out of profiling activities and marketing communications. 3. Confirm that the information you have provided is correct and that you have read and accepted the terms and conditions of the service overleaf.

Customer’s Signature

Date (DD/MM/YYYY)

OFFICE USE ONLY

Attach Duplicate Transaction	Money Transfer Control Number	Staff Name	Staff Signature	Date (DD/MM/YYYY)
Receipt to this copy

Office copy	8839661 • Oct 2017

Fanapart glue

210mm X 297mm_IAP_03112017_8839661_Page 1

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SUMMARY OF THE WESTERN UNION® MONEY TRANSFERSM SERVICE TERMS AND CONDITIONS (FOR THE FULL TERMS AND CONDITIONS, PLEASE ASK ANY WESTERN UNION AGENT OR VISIT WWW.WESTERNUNION.COM.AU)

Western Union® Money TransferSM transactions can be sent and picked up at most Western Union® Agent locations worldwide. Regular money transfers are usually available within minutes for pick up by the receiver, subject to the opening hours of the receiving Western Union Agent (“Agent”) location. Exceeding amount limitations, regulatory restrictions or other restrictions in certain countries may delay the transaction. Western Union does not act as the agent or representative of any bank for any purpose and does not accept deposits on behalf of any bank.

Money transfers will normally be paid in cash, but some Agents may pay by cheque or a combination of cash and cheque or may offer or the receiver may choose other ways to receive funds and some money transfers may be paid to accounts. All cash payments are subject to availability, receivers showing documentary evidence of their identity and providing all details about the money transfer required by Western Union, including sender’s and receiver’s names, country of origin, approximate sum, money transfer control number and any other conditions or requirements applicable at the Agent location. The sender authorizes Western Union to honor the receiver’s choice of method to receive funds even if it differs from the sender’s. Cash money transfers shall be paid to the person that Agents deem entitled to receive the transaction after verification of identity often through examination of identification documents. Such payment can be made even when the form filled out by the receiver contains errors. Neither Western Union nor its Agents carry out a comparison of the “To Send Money” form against the “To Receive Money” form to verify the address given for the receiver. In some destinations the receiver may be required to provide identification, a test question answer or both to receive funds in cash. Test questions are not an additional security feature and cannot be used to time or delay the payment of a transaction and are prohibited in certain countries. Applicable law prohibits money transmitters from doing business with certain individuals and countries. Customers are sometimes required to provide additional identification or information, delaying transactions.

TRANSFER FEES: Written information explaining how Western Union charges the sender for making a money transfer will either be displayed prominently at the Agent location or shown to the sender prior to completion of the payment order. In certain cases, payment of a money transfer may be subject to local taxes and service charges. FOREIGN EXCHANGE: Money transfer payments will normally be made in the currency of the destination country. In addition to the transfer fee applicable to each transfer and if the currency which the sender presents to an Agent is not the currency to be received by the receiver, all currency is converted at Western Union’s then current rate of exchange. The currency will be converted at the time of transfer and the receiver will receive the foreign currency amount shown on the Transaction Receipt. In a few countries local regulations require the currency to be converted at the time the receiver is paid, in which case the exchange rate and any amounts shown on the Transaction Receipt may be subject to exchange rate fluctuations between the time of transfer and the time the receiver collects the funds.

SPECIAL SERVICES: Where available, Western Union offers free SMS notification to indicate that the transaction has been collected by the receiver (for the sender) or that funds are available for collection (for the receiver). Western Union will send SMS messages to a third party gateway for delivery. ACCOUNT BASED TRANSFERS: Where available, the receiver may incur additional fees for receiving the sender’s funds through a mobile telephone or to a bank or other account. Additional costs or delay may occur if transfers are not sent to a local (receiver) currency account. The receiver’s agreement with its mobile phone service, mWallet, bank or other account provider governs the account and determines their rights, liability, fees, funds availability and account limitations. In the event that the account number provided (including mobile phone numbers for mobile accounts) does not belong to the named receiver, the transfer will be credited to the account number provided by the sender. Western Union may make money from fees associated with use of an account. REFUND - Western Union will refund the principal amount of a money transfer upon the sender’s written request if payment has not made or credited. Transfer fees are not refunded if the transfer is stopped at the sender’s request.

LIABILITY: Western Union disclaims all liability in respect of the sender’s relationship with the receiver, without limitation, in respect of the delivery or suitability of any goods or services paid for by means of a Western Union money transfer. The sender’s transaction data is confidential to him and should not be shared with any other person other than his receiver. The sender is cautioned against sending money to any person he does not know. In no event shall Western Union or any of its Agents be liable if the sender communicates transactional data to any person other than his receiver. To the extent permitted by law, in no event shall Western Union or any of its Agents be liable for damages for delay, nonpayment or underpayment of this money transfer, or non-delivery of any supplemental message, whether caused by negligence on the part of their employees or agents or otherwise, beyond the sum equivalent to US$500 (in addition to refunding the principal amount of the money transfer and the transfer fee). In no event will Western Union or its Agents be liable for any indirect, special, incidental, or consequential damages. The foregoing disclaimer shall not limit Western Union’s or Agent’s liability for damages resulting from Western Union’s or Agent’s gross negligence or intentional misconduct in those jurisdictions where such a limitation of liability is void. The foregoing disclaimer shall not exclude Western Union’s nor its Agent’s liability for any condition or warranty that cannot be excluded by law including any implied warranty that it will render services with due care and skill, and Western Union’s and its Agent’s liability for breach of such condition or warranty shall be limited to the greater of the cost of providing the affected service again and the sum equivalent to US$500.

DATA PROTECTION: Your personal information is processed under applicable laws and is controlled & used by Western Union for the purposes of providing the requested services. Your information is used to provide you with the services you have asked for and may also be used in connection with other services, products, convenience and/or rewards programs, you signed up for with Western Union or its affiliates, and, subject to your choices, send you commercial communications. Providing your information and that of the receiver of our services is voluntary but necessary to execute the transaction. You consent to Western Union disclosing or transferring your information and Third Party Information to third parties to carry out transactions. Western Union may also disclose such information to third parties, where reasonably necessary, for the purposes of the prevention, detection, investigation and prosecution of crime, or when required by law, and the recipients may further disclose the information for these and other related purposes. If you wish to exercise your rights to access, request a copy, correct, erase or block your information or no longer wish to receive commercial communications from Western Union, please call 1800 501 500 (free calls from landlines and public phones, standard mobile charges apply check with your network provider) during regular business hours.

Effective 29 December 2015, the service in Australia is provided by a network of authorised independent agents and representatives in conjunction with Western Union Financial Services, Inc. (for money transfers from the United States, Canada, and Mexico, and for commercial services transactions) and Western Union (Ireland) Partnership (for all other transactions), through a network of authorised Agents and representatives (outside Australia).

8839661 • Oct 2017

210mm X 297mm_IAP_03112017_8839661_Page 1 (BACK)

P417U

1800 501 500

*1235 Send Money

*1236 Receive Money

CUSTOMER NAME

PLEASE PRINT CLEARLY. Identification is required for all customers: Current Passport, Australian Drivers Licence or Proof of Age Card.

Full Legal	First	Middle	Last
Name

EXISTING CUSTOMERS

NEW CUSTOMERS

or updated details for existing customers

Mobile Number

Western Union Customer Number

Address (Post office box addresses are not permitted)

Suburb

State

Postcode

Country of Citizenship (must have)

Mobile Number

Date of Birth (DD/MM/YYYY)

Country of Birth (must have)

To send money, complete this section

TRANSACTION DETAILS

OPTIONAL

SERVICES FOR SENDING

Destination Country

Destination Currency		Amount to be Sent.	Australian Dollars	$		or	Payout Amount Destination
		Complete one only.	(AUD)	$		or

	I want the money sent
	I want the money sent	Bank Name			Bank Code / BIC
	direct to a Bank Account
	direct to a Bank Account

Account Name		Bank Location (City)			Account Number / IBAN

I want the money sent to a mobile

Country Code

Mobile Number

RECEIVER’S	Western Union wants to help you avoid being exposed to fraud. If you don’t know the person you’re sending to, we recommend you do not send.
DETAILS	Neither Western Union nor its Agents carry out a comparison of the “To Send Money” form against the “To Receive Money” form to verify the address given for the receiver.
	Full Legal	First	Middle	Last

	Name

	Current Address		(Post office box addresses are not permitted)

City / Suburb

State / Province

Postcode

Country

TEST QUESTION

Not required for all countries. If unsure if this is required, ask at the counter for further details.

Question

Answer

To receive money, complete this section

All fields must be completed

Money Transfer Control Number

Amount Expected

Originating Country

(AUD)

Sender’s

First

Middle

Last

Name

CUSTOMER’S SIGNATURE

All customers to complete this section

Customer’s Signature

Date (DD/MM/YYYY)

OFFICE USE ONLY

Attach Transaction Receipt	Money Transfer Control Number	Staff Name	Staff Signature	Date (DD/MM/YYYY)
to this copy

Customer copy

8839661 • Oct 2017

210mm X 297mm_IAP_03112017_8839661_Page 2

PGREENUP417UP109UBLACK

210mm X 297mm_IAP_03112017_8839661_Page 2 (BACK)

P186UPGREENUP417UP109UBLACK

Documents used along the form

When utilizing Western Union services, several other forms and documents may be necessary to ensure a smooth transaction. These documents help verify identity, provide transaction details, and comply with regulatory requirements. Below is a list of commonly used forms alongside the Western Union form.

Identification Document: A government-issued ID, such as a passport or driver's license, is required to verify the sender's identity. This helps prevent fraud and ensures compliance with financial regulations.
Lease Agreement Documentation: For those involved in rental agreements, it's important to have access to a reliable lease agreement template, such as the one provided at legalpdfdocs.com/, to ensure all terms and conditions are clearly specified.
Money Transfer Receipt: After completing a transaction, the receipt serves as proof of payment. It includes details like the transaction number, amount sent, and recipient information.
Sender’s Declaration Form: This form may be needed to confirm the purpose of the money transfer. It provides additional information to comply with anti-money laundering regulations.
Recipient’s Identification: The recipient may need to present their own identification when collecting the funds. This ensures that the money is released to the correct person.
Compliance Forms: Depending on the amount and destination, additional compliance forms may be required. These documents help Western Union adhere to international money transfer laws.
Transaction Tracking Form: For monitoring the status of a money transfer, this form can be used. It allows both sender and recipient to track the progress of the transaction.

Understanding these documents is crucial for anyone looking to send or receive money through Western Union. Having the right forms ready can expedite the process and help avoid potential issues.

Similar forms

The Western Union form is a crucial document used for money transfers, but it shares similarities with several other important financial documents. Understanding these similarities can help you navigate the world of financial transactions more effectively. Below is a list of eight documents that are similar to the Western Union form, along with a brief explanation of how they relate to it.

MoneyGram Transfer Form: Like the Western Union form, this document facilitates the transfer of funds between individuals. It requires sender and receiver information and transaction details.
PayPal Transaction Receipt: This receipt confirms a digital money transfer, similar to how the Western Union form serves as proof of a cash transfer, detailing the sender, receiver, and amount.
Wire Transfer Request Form: This form is used to initiate a bank wire transfer. Both documents require similar information about the parties involved and the amount being transferred.
Check Payment Stub: A check stub provides details about a payment made via check, similar to how the Western Union form provides transaction details for cash transfers.
Durable Power of Attorney: This legal document, exemplified by the Durable Power of Attorney, allows an individual to manage financial and legal matters on behalf of another, ensuring that trusted choices are made even in times of incapacity.
Venmo Payment Confirmation: This digital payment confirmation serves as proof of a transaction, akin to the Western Union form, which acts as a receipt for cash transfers.
Western Union Money Order: This document is used for sending money orders, similar to the Western Union form, as both require sender and receiver information and serve as proof of payment.
TransferWise Transaction Confirmation: This confirmation details an international money transfer, much like the Western Union form, providing transparency about the transaction details.
Cryptocurrency Transaction Receipt: This receipt documents a digital currency transfer, paralleling the Western Union form by providing essential details about the transaction and the parties involved.

Each of these documents plays a vital role in facilitating financial transactions, ensuring that both senders and receivers have a clear record of the transfer process.

Misconceptions

When dealing with the Western Union form, misunderstandings can lead to confusion. Here are ten common misconceptions that people often have about this form:

All Western Union transactions require a form.
Not every transaction requires a formal Western Union form. Some transactions can be completed online or through the app without filling out a physical form.
The form is only for sending money internationally.
This is not true. The Western Union form can be used for both domestic and international money transfers, making it versatile for various needs.
You must have a bank account to use the form.
Many people believe a bank account is necessary, but you can send money using cash at an authorized location without needing a bank account.
All information on the form is optional.
While some fields may seem optional, providing complete and accurate information is crucial for the transaction to be processed smoothly.
Once submitted, the form cannot be changed.
In many cases, you can request changes to your transaction, but it’s best to do so as soon as possible to avoid complications.
The form is only for personal use.
This misconception overlooks that businesses can also use Western Union forms for commercial transactions, making it useful for various purposes.
You need to fill out the form in person.
While in-person transactions are common, you can also complete the form online, which adds convenience for many users.
There are no fees associated with using the form.
Many people assume the service is free, but fees typically apply depending on the amount sent and the destination.
All forms are the same regardless of location.
Forms may vary slightly based on the country or state due to different regulations and requirements, so it’s important to use the correct form for your location.
Once the money is sent, you cannot track it.
This is a common myth. Western Union provides tracking options for your transaction, allowing you to monitor its status after sending.

Understanding Western Union

What is the Western Union form?

The Western Union form is a document used to facilitate money transfers through Western Union. It captures essential information about the sender, receiver, and the transaction details. This form helps ensure that the transfer is processed accurately and securely.
How do I fill out the Western Union form?

To fill out the form, you will need to provide your personal information, including your name, address, and contact details. You will also need to enter the recipient's information, including their name and location. Be sure to double-check all entries for accuracy to avoid delays.
What information is required on the form?

The form typically requires the following information:
- Sender's full name and address
- Recipient's full name and address
- Amount being sent
- Purpose of the transfer
- Payment method (cash, debit, or credit card)
Where can I obtain a Western Union form?

You can obtain a Western Union form at any Western Union location. Additionally, many forms are available online through the Western Union website or mobile app. You can print the form if you choose to fill it out before visiting a location.
Can I submit the form online?

Yes, Western Union offers an online platform where you can complete the transfer without needing to visit a physical location. You will need to create an account or log in to access the online form. Make sure you have all the necessary information ready before starting.
What should I do if I make a mistake on the form?

If you notice an error after submitting the form, contact Western Union customer service immediately. They can guide you on how to correct the mistake. If the form has not yet been processed, changes may be made easily.
Is there a fee for using the Western Union form?

Yes, there is usually a fee associated with sending money through Western Union. The fee may vary based on the amount sent, the destination, and the payment method used. Always check the fee structure before completing the transaction.
How long does it take for the transfer to be completed?

The transfer time can vary. In many cases, the funds are available for pickup within minutes. However, some transfers may take longer, especially if sent internationally or if additional verification is needed. You can track the status of your transfer online.
What should I do if the recipient does not receive the funds?

If the recipient has not received the funds, first confirm that the transaction was completed on your end. You can use the tracking number provided to check the status. If there are still issues, contact Western Union customer service for assistance.