Western Union Online Receipt Generator Details

Western Union, a company that provides money transfer services, released a blank form to its customers. The release of this document comes as no surprise because the company has been making changes to its policies and procedures in order to provide better service. This new form allows customers to transmit money without having to go through a Western Union agent. The release of this blank form coincides with the phasing out of the old Money Transfer Form (MTF), which will be retired on September 30, 2017. The MTF was introduced over fifteen years ago and is due for an update. The new Western Union Blank Form will allow customers to save time by completing the entire process online, including paying for the transaction.

In the list, there's some good information regarding the western union blank form. Before you fill in the form, it's worth reading through a little more about it.

QuestionAnswer
Form NameWestern Union Blank Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameswestern union money transfer receipt pdf, western union receipt online, western union receipt, western union receipt generator

Form Preview Example

Western Union Financial Services, Inc.

PO Box 7030

Englewood, Colorado 80155-703

1-800-999-9660

MONEY ORDER AFFIDAVIT

STATE: __________________________________)

COUNTY: ________________________________)

I, ___________________________________________________ , at__________________________________ and

(Full Legal Name )(Daytime Phone Number)

of __________________________________________________________________________________________,

 

Street

City

State

Zip Code

duly sworn, do depose and say:

 

 

 

A) I am the

 

PAYEE /

 

PURCHASER (mark one) of the money order issued by Western Union

 

 

Financial Services, Inc., or Integrated Payment Systems Inc. (“Money Order”), described below:

Money Order Number:

(11 Digits)

Face Amount of Money Order:

“Purchaser” Name:

(Who purchased the Money Order)*

“Payee” Name

(Who the Money Order is payable to)*

I am requesting this refund on behalf of a

Company. (Yes or No)*

Date and time of Money Order Purchase:

Name and Address of Western Union Agent

Location Where The Money Order was

Purchased

* if the party requesting a refund is a company (e.g. a corporation, LLC, etc.) please also complete page 2.

B)Upon information and belief, the Money Order was _____________________________________________; and

(Lost, destroyed, stolen, etc.)

C)Neither the Purchaser, nor the Payee, has cashed, negotiated, deposited, transferred, received payment or received a benefit of any kind, directly or indirectly, from the Money Order.

THEREFORE: To induce Western Union Financial Services, Inc and/or Integrated Payment Systems Inc. (collectively, “Western Union”) to refund the face amount of the Money Order and in consideration of such payment, I authorize Western Union to issue a stop payment order on the Money Order, and I agree to pay Western Union a $15.00 non-refundable processing fee for this request; I understand that if the Money Order has been paid, I will only receive a copy of the Money Order and not a refund. I agree to indemnify and hold Western Union harmless against any and all damages, costs, expenses and/or liability arising out of, or otherwise connected with, my representations herein, including any actions taken by Western Union in reliance upon such representation, this refund, the Money Order, or as a result of the negotiation of the Money Order.

_________________________________________________________

SignatureDate

Subscribed and sworn to before me this ____________________day of _____________________20_________

My commission expires: ____________________________________

 

__________________________________________________________

 

NOTARY PUBLIC

(Notary Stamp, if applicable)

Page 1

Western Union Financial Services, Inc.

PO Box 7030

Englewood, Colorado 80155-703

1-800-999-9660

MONEY ORDER AFFIDAVIT-COMPANY ADDENDUM

STATE: __________________________________)

COUNTY: ________________________________)

I, ___________________________________________________, am the __________________________________

(Full Legal Name )(Formal Business Title or Position)

of _______________________________________________________(the “Company”) ,

(Legal Name of Entity)

a ______________________ organized, incorporated or existing under the laws of the state of ________________,

(State Entity Type, e.g. Corp., LLC, etc, )

(State of Incorporation or Organization)

and with its principal place of business located at:

______________________________________________________________________________________,

Street

City

State

Zip Code

being duly sworn, do depose and say:

A)I am requesting a refund of the face value of the Money Order, and executing this Affidavit on behalf of the Company; and

B)I have the power and authority to act on Company’s behalf, including the power to request this refund and execute this Affidavit on Company’s behalf; and

C)Neither the Company, nor any person acting on Company’s behalf, has cashed, negotiated, deposited, transferred, received payment or received a benefit of any kind, directly or indirectly, from the Money Order;

________________________________________________________

SignatureDate

Subscribed and sworn to before me this ______________day of ____________________20_________.

My commission expires: ____________________________________.

__________________________________________________________

 

NOTARY PUBLIC

(Notary Stamp, if applicable)

Page 2

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