Valley National Bank Wire Transfer

--- ## Page 1 The user wants me to transcribe all visible text on the page as clean markdown. I need to: 1. Transcribe ALL visible text exactly as shown 2. Use ### for sections 3. Use **bold** for labels 4. Use markdown tables for tabular data 5. Use - bullets for lists 6. Preserve all numbers, dates, and values exactly as shown 7. No commentary, no analysis, no preamble, no "The document is..." sentences 8. Start directly with the content Let me carefully read through the document and transcribe it. First, the header section: - Valley logo - VALLEY NATIONAL BANK ("Valley") - Wire Transfer Form ("Payment Order") Then the form fields: - Today's Date: 18-FEB-2026 - Transfer Date: 18-FEB-2026 - Branch Name: RETAIL BANKING DISTRICT 9 (R09) - Branch Code: R09 - Originator's Account #: 500072269 - Online Institution's Routing Number: PNBPUS3NNYC - Wire Number: 202602180016720 - Wire Amount: USD 10,533.50 - Service Charge: 90.00 - Product Code: (empty) - Debit Amount: USD 10,623.50 - Exchange Rate: 0.00 - (CrGL4275) - Beneficiary may receive less due to fees charged by the beneficiary's bank and foreign taxes - Created By: NICOLE BROUSE - Telegraphic Name: WELLS FARGO BANK, N.A. - Name of Originator: JOHAN JONGSMA - Taxpayer ID: (empty) - Address of Originator: 851 BRIGHTWATERS BLVD NE, ST PETERSBURG FL 33704-3719 - Corresponding Institution (If Beneficiary's Bank is offline or Outside the United States) - Beneficiary Institution (Final Destination Bank's Name & Address): MASHREQBANK PSC., MASHREQ HQ BURJ AL SHAMS 345, 1250 DUBAI, UNITED ARAB EMIRATES - Beneficiary's Name (Final Recipient of Funds): IULIA PROKOPEVA - Beneficiary's Address (required): DUBAI, JVT, IVY TOWER UNIT 813, UAE - Beneficiary's Account Number (required): AE210330000019101369369 - Other Beneficiary Information, Reference Information, or Payment Instructions: ACCOUNT # 019101369369 Then the terms and conditions section: - WIRE TRANSFER TERMS AND CONDITIONS("Terms and Conditions") AUTHORIZATION section... PROCESSING PAYMENT ORDER section... BENEFICIARY AND BANK INFORMATION section... CANCELING OR AMENDING PAYMENT ORDERS section... Footer: © Valley National Bank. Member FDIC. Equal Opportunity Lender. All Rights Reserved. Let me format this properly with markdown. For the top section with the logo and bank name, I'll include the text. For the form fields, I should organize them in a readable way. Since there are many fields, I might use a table or just list them with bold labels. Looking at the layout: - First row: Today's Date, Transfer Date - Second row: Branch Name, Branch Code - Third row: Originator's Account #, Online Institution's Routing Number - Fourth row: Wire Number, Wire Amount, Service Charge, Product Code - Fifth row: Debit Amount, Exchange Rate - Then the note about (CrGL4275) and beneficiary receiving less - Created By Let me structure this carefully. Actually, looking at the document more carefully, I should preserve the layout as much as possible while making it clean markdown. Let me transcribe section by section: **Header:** Valley National Bank logo text: "Valley" and the arrow logo (I'll just include the text "Valley" since that's what's visible) Title: VALLEY NATIONAL BANK ("Valley") Wire Transfer Form ("Payment Order") **Form Data:** I'll organize this in a table or as field listings. Let me try to be precise: | Field | Value | |-------|-------| | Today's Date | 18-FEB-2026 | | Transfer Date | 18-FEB-2026 | | Branch Name | RETAIL BANKING DISTRICT 9 (R09) | | Branch Code | R09 | | Originator's Account # | 500072269 | | Online Institution's Routing Number | PNBPUS3NNYC | | Wire Number | 202602180016720 | | Wire Amount | USD 10,533.50 | | Service Charge | 90.00 | | Product Code | | | Debit Amount | USD 10,623.50 | | Exchange Rate | 0.00 | But wait, the layout has Wire Number and Wire Amount on the same line, and Service Charge and Product Code on the same line. Let me look again. Actually, looking at the image: - Wire Number: 202602180016720 - Wire Amount: USD 10,533.50 - Service Charge: 90.00 - Product Code: (empty box) - Debit Amount: USD 10,623.50 - Exchange Rate: 0.00 And there's text: "(CrGL4275)" and "Beneficiary may receive less due to fees charged by the beneficiary's bank and foreign taxes" Created By: NICOLE BROUSE Then: Telegraphic Name: WELLS FARGO BANK, N.A. Name of Originator: JOHAN JONGSMA Taxpayer ID: (blank) Address of Originator: 851 BRIGHTWATERS BLVD NE, ST PETERSBURG FL 33704-3719 Corresponding Institution (If Beneficiary's Bank is offline or Outside the United States) Beneficiary Institution (Final Destination Bank's Name & Address): MASHREQBANK PSC., MASHREQ HQ BURJ AL SHAMS 345, 1250 DUBAI, UNITED ARAB EMIRATES Beneficiary's Name (Final Recipient of Funds): IULIA PROKOPEVA Beneficiary's Address (required): DUBAI, JVT, IVY TOWER UNIT 813, UAE Beneficiary's Account Number (required): AE210330000019101369369 Other Beneficiary Information, Reference Information, or Payment Instructions: ACCOUNT # 019101369369 Then the legal text sections... Let me format this cleanly. I think the best approach is to use ### for the main title, then use **bold** for field labels, and organize the form fields in a clear structure. For the legal text at the bottom, I should preserve the paragraphs and formatting with bold section headers. Let me start: ### VALLEY NATIONAL BANK ("Valley") ### Wire Transfer Form ("Payment Order") **Today's Date:** 18-FEB-2026 **Transfer Date:** 18-FEB-2026 **Branch Name:** RETAIL BANKING DISTRICT 9 (R09) **Branch Code:** R09 **Originator's Account #:** 500072269 **Online Institution's Routing Number:** PNBPUS3NNYC **Wire Number:** 202602180016720 **Wire Amount:** USD 10,533.50 **Service Charge:** 90.00 **Product Code:** **Debit Amount:** USD 10,623.50 **Exchange Rate:** 0.00 (CrGL4275) Beneficiary may receive less due to fees charged by the beneficiary's bank and foreign taxes **Created By:** NICOLE BROUSE **Telegraphic Name:** WELLS FARGO BANK, N.A. **Name of Originator:** JOHAN JONGSMA **Taxpayer ID:** **Address of Originator:** 851 BRIGHTWATERS BLVD NE ST PETERSBURG FL 33704-3719 **Corresponding Institution** (If Beneficiary's Bank is offline or Outside the United States) **Beneficiary Institution** (Final Destination Bank's Name & Address) MASHREQBANK PSC. MASHREQ HQ BURJ AL SHAMS 345 1250 DUBAI UNITED ARAB EMIRATES **Beneficiary's Name (Final Recipient of Funds):** IULIA PROKOPEVA **Beneficiary's Address (required):** DUBAI, JVT, IVY TOWER UNIT 813 UAE **Beneficiary's Account Number (required):** AE210330000019101369369 **Other Beneficiary Information, Reference Information, or Payment Instructions:** ACCOUNT # 019101369369 --- ### WIRE TRANSFER TERMS AND CONDITIONS("Terms and Conditions") **AUTHORIZATION:** Customer authorizes Valley to debit the deposit account identified above to cover the total amount of the wire transfer on this Payment Order, inclusive of all applicable fees. **PROCESSING PAYMENT ORDER:** Valley will use commercially reasonable efforts to execute this Payment Order on the date that it is received, provided the Payment Order is received by Valley before 3:00 P.M. (the "Cutoff Time") on a business day for Valley, the funds transfer system, and any receiving financial institution. If this Payment Order is received by Valley after the Cutoff Time, it will be treated as received on the next business day. Valley reserves the right to change the Cutoff Time at its sole discretion. Valley may reject any Payment Order for any reason at its sole discretion. If Valley rejects a Payment Order, Valley will notify the Customer orally, electronically, or in writing. Valley is not liable for any rejection and is not obligated to pay interest for the period before the Customer receive the notice of rejection. **BENEFICIARY AND BANK INFORMATION:** Customer must provide Valley with comprehensive and accurate beneficiary information, including the full name and address of the beneficiary, the complete name and address of the beneficiary's financial institution, the precise account number of the beneficiary at that financial institution, and the correct SWIFT or Fedwire code for the intermediary and beneficiary banks. It is the sole and exclusive obligation of the Customer to ensure that the account number of the beneficiary and the identification of the beneficiary's financial institution (and any specified intermediary bank) are correct. Valley shall have no obligation to compare or otherwise ascertain that the name of any bank agrees with the identification number of any bank as provided by the Customer. In the event of any inconsistency between the beneficiary's name and account number, the account number will control. Similarly, in the event of any inconsistency between the name of the beneficiary's financial institution and the SWIFT/Fedwire code, the SWIFT/Fedwire code will control. Valley will not be liable for executing the Payment Order based on the beneficiary's account number or SWIFT/Fedwire code in this Payment Order. Customer confirms that all information set forth on this Payment Order is accurate and assumes all risk of loss for any incorrect or inconsistent information. Valley shall not be responsible for any resulting errors or misdirected funds. **CANCELING OR AMENDING PAYMENT ORDERS:** Any request to cancel the Payment Order must be received by Valley before the Payment Order is executed. Valley will treat any request to amend a Payment Order as a request to cancel it. Valley will make commercially reasonable efforts to act on a timely request to cancel a Payment Order; however, Valley does not guarantee that the Payment Order will be canceled. Valley shall not be liable for any failure to cancel a Payment Order, regardless of the reason. The Customer acknowledges that once a Payment Order has been executed, it cannot be canceled or amended. The Customer assumes all risk and liability for any losses or damages resulting from the failure to cancel or amend a Payment Order. --- © Valley National Bank. Member FDIC. Equal Opportunity Lender. All Rights Reserved. --- Wait, I need to check the text in the image more carefully. Let me look at the legal sections again to make sure I have the exact wording. Looking at AUTHORIZATION: "Customer authorizes Valley to debit the deposit account identified above to cover the total amount of the wire transfer on this Payment Order, inclusive of all applicable fees." PROCESSING PAYMENT ORDER: "Valley will use commercially reasonable efforts to execute this Payment Order on the date that it is received, provided the Payment Order is received by Valley before 3:00 P.M. (the "Cutoff Time") on a business day for Valley, the funds transfer system, and any receiving financial institution. If this Payment Order is received by Valley after the Cutoff Time, it will be treated as received on the next business day. Valley reserves the right to change the Cutoff Time at its sole discretion. Valley may reject any Payment Order for any reason at its sole discretion. If Valley rejects a Payment Order, Valley will notify the Customer orally, electronically, or in writing. Valley is not liable for any rejection and is not obligated to pay interest for the period before the Customer receive the notice of rejection." BENEFICIARY AND BANK INFORMATION: "Customer must provide Valley with comprehensive and accurate beneficiary information, including the full name and address of the beneficiary, the complete name and address of the beneficiary's financial institution, the precise account number of the beneficiary at that financial institution, and the correct SWIFT or Fedwire code for the intermediary and beneficiary banks. It is the sole and exclusive obligation of the Customer to ensure that the account number of the beneficiary and the identification of the beneficiary's financial institution (and any specified intermediary bank) are correct. Valley shall have no obligation to compare or otherwise ascertain that the name of any bank agrees with the identification number of any bank as provided by the Customer. In the event of any inconsistency between the beneficiary's name and account number, the account number will control. Similarly, in the event of any inconsistency between the name of the beneficiary's financial institution and the SWIFT/Fedwire code, the SWIFT/Fedwire code will control. Valley will not be liable for executing the Payment Order based on the beneficiary's account number or SWIFT/Fedwire code in this Payment Order. Customer confirms that all information set forth on this Payment Order is accurate and assumes all risk of loss for any incorrect or inconsistent information. Valley shall not be responsible for any resulting errors or misdirected funds." CANCELING OR AMENDING PAYMENT ORDERS: "Any request to cancel the Payment Order must be received by Valley before the Payment Order is executed. Valley will treat any request to amend a Payment Order as a request to cancel it. Valley will make commercially reasonable efforts to act on a timely request to cancel a Payment Order; however, Valley does not guarantee that the Payment Order will be canceled. Valley shall not be liable for any failure to cancel a Payment Order, regardless of the reason. The Customer acknowledges that once a Payment Order has been executed, it cannot be canceled or amended. The Customer assumes all risk and liability for any losses or damages resulting from the failure to cancel or amend a Payment Order." Footer: "© Valley National Bank. Member FDIC. Equal Opportunity Lender. All Rights Reserved." I need to make sure I capture the logo text at the top. The logo shows "Valley" with the stylized V. Also, I should note that in the form section, "Wire Amount" is USD 10,533.50 and "Debit Amount" is USD 10,623.50. The difference is the service charge of 90.00. One detail: The text "Beneficiary may receive less due to fees charged by the beneficiary's bank and foreign taxes" appears to the right of "Created By" and below the Exchange Rate field. Let me also check if there are any table structures in the original. The form has boxes and lines, but it's not really a table - it's a form with fields. I think using bold labels and line breaks is appropriate. Actually, looking at the document again, I see that some fields are arranged side by side. But for a clean transcription, listing them with bold labels is fine and readable. Let me double-check all the numbers and codes: - Account #: 500072269 - Routing Number: PNBPUS3NNYC - Wire Number: 202602180016720 - Wire Amount: USD 10,533.50 - Service Charge: 90.00 - Debit Amount: USD 10,623.50 - Exchange Rate: 0.00 - Reference: (CrGL4275) - Originator: JOHAN JONGSMA - Originator Address: 851 BRIGHTWATERS BLVD NE, ST PETERSBURG FL 33704-3719 - Telegraphic Name: WELLS FARGO BANK, N.A. - Beneficiary Bank: MASHREQBANK PSC., MASHREQ HQ BURJ AL SHAMS 345, 1250 DUBAI, UNITED ARAB EMIRATES - Beneficiary: IULIA PROKOPEVA - Beneficiary Address: DUBAI, JVT, IVY TOWER UNIT 813, UAE - Account: AE210330000019101369369 - Reference Info: ACCOUNT # 019101369369 Everything looks correct. One more check on the legal text - I want to make sure I have the exact wording and punctuation. In the BENEFICIARY AND BANK INFORMATION section, I see: "Valley will not be liable for executing the Payment Order based on the beneficiary's account number or SWIFT/Fedwire code in this Payment Order. Customer confirms that all information set forth on this Payment Order is accurate and assumes all risk of loss for any incorrect or inconsistent information." And: "Valley shall not be responsible for any resulting errors or misdirected funds." In the CANCELING section: "any lo ses or damages" - wait, looking closely at the image, is it "lo ses" or "losses"? Let me look. Looking at the text: "any lo sses or damages" - it appears there might be a line break or hyphenation. Let me look more carefully. Actually, looking at the image, the text says: "any losses or damages" Wait, I need to zoom in mentally on that part. The text says: "The Customer assumes all risk and liability for any lo sses or damages resulting from the failure to cancel or amend a Payment Order." Actually, looking at the image more carefully, it looks like "any losses or damages" - the word is "losses". The OCR or my visual parsing might have seen a hyphenation or line break, but in the image, it appears to be on one line: "any losses or damages". Let me check the image one more time for that specific part. Looking at the bottom section, the CANCELING OR AMENDING PAYMENT ORDERS paragraph: "The Customer assumes all risk and liability for any losses or damages resulting from the failure to cancel or amend a Payment Order." Yes, it's "losses". Also, in the PROCESSING PAYMENT ORDER section: "Customer receive the notice" - should be "receives"? But I need to transcribe exactly what's there. It says "before the Customer receive the notice of rejection." And in BENEFICIARY AND BANK INFORMATION: "Customer confirms that all information --- ## Page 2 **Valley** Wire Number: 202602180016720 ### Terms and Conditions Continued **LIMITATION OF LIABILITY:** Except as provided under applicable law, (i) Valley shall be liable only for direct damages resulting from Valley's gross negligence or willful misconduct in connection with this Payment Order; (ii) Valley shall not be responsible for Customer's acts or omissions (including the amount of the wire transfer, accuracy of the information provided, or timeliness of when Customer signs this --- ## Page 3 ### VALLEY NATIONAL BANK **Today's Date:** FEBRUARY 18, 2026 13:37 **Transfer Date:** FEBRUARY 18, 2026 ### NOT A RECEIPT **Sender:** JOHAN JONGSMA 851 BRIGHTWATERS BLVD NE ST PETERSBURG FL 33704-3719 **Recipient:** IULIIA PROKOPEVA DUBAI, JVT, IVY TOWER UNIT 813 UAE **Pick-Up Location:** MASHREQBANK PSC. MASHREQ HQ BURJ AL SHAMS 345 1250 DUBAI UNITED ARAB EMIRATES **Date Available:** FEBRUARY 25, 2026 **Transfer Amount:** 10,533.50 USD **Transfer Fees:** +90.00 USD **Total:** 10,623.50 USD **Transfer Amount:** 10,533.50 USD **Other Fees:** -19.50 USD **Total to Recipient:** 10,514.00 USD RECIPIENT MAY RECEIVE LESS DUE TO FEES CHARGED BY THE RECIPIENT'S BANK AND LOCAL TAXES. YOU HAVE THE RIGHT TO DISPUTE ERRORS IN YOUR TRANSACTION. IF YOU THINK THERE IS AN ERROR, CONTACT US WITHIN 180 DAYS AT 800.522.4100 OR YOUR PRIVATE BANKER/ RELATIONSHIP MANAGER OR WWW.VALLEY.COM. YOU CAN ALSO CONTACT US FOR A WRITTEN EXPLANATION OF YOUR RIGHTS. YOU CAN CANCEL FOR A FULL REFUND WITHIN 30 MINUTES OF PAYMENT, UNLESS THE FUNDS HAVE BEEN PICKED UP OR DEPOSITED. FOR QUESTIONS OR COMPLAINTS ABOUT VALLEY NATIONAL BANK, CONTACT: NEW JERSEY DEPT. OF BANKING AND CONSUMER INQUIRY AND RESPONSE CENTER AND/OR CONSUMER FINANCIAL PROTECTION BUREAU BELOW: | State Regulatory Agency | 609-292-7272 | HTTPS://WWW.DOBI.NJ.GOV/ | |---|---|---| | Consumer Financial Protection Bureau | 855-411-2372
855-729-2372 (TTY/TDD) | WWW.CONSUMERFINANCE.GOV | By signing below, you authorize payment from the designated account | Authorized Signature (and Title, if applicable) | Date | Time | |---|---|---| © Valley National Bank. Member FDIC. Equal Opportunity Lender. All Rights Reserved.