Fedwire^® Contingency Test Registration Form

For questions related to this sign-up form, please contact the Support Center at (833) 377-7827, and select Option 3 for Fedwire Services.

Please print this page for your records after you have completed the form. Then, click "Submit" to complete your registration.

* Required fields

Section 1: Testing Date Selection

Test Date *

Section 2: Customer Information

Institution ABA Number *

(9 Digit)

Institution Name

Operational Contact

First Name *

Last Name *

Phone Number

Please enter your 10-digit phone number without hyphens. For example XXXXXXXXXX.

Phone Number Extension

Email Address *

Requested by

(if different than operational contact above)

First Name

Last Name

Phone Number

Please enter your 10-digit phone number without hyphens. For example XXXXXXXXXX.

Phone Number Extension

Email Address

ASP Vendor

(if applicable)

Name of Vendor

Contact First Name

Contact Last Name

Phone Number

Please enter your 10-digit phone number without hyphens. For example XXXXXXXXXX.

Phone Number Extension

Vendor Contact Email Address

MQ Support Contact

First Name

Last Name

Phone Number

Please enter your 10-digit phone number without hyphens. For example XXXXXXXXXX.

Phone Number Extension

Email Address

Next-Level Officer Contact

The financial institution officer used for escalation purposes if the operational contact listed above cannot be reached.

First Name *

Last Name *

Phone Number *

Please enter your 10-digit phone number without hyphens. For example XXXXXXXXXX.

Phone Number Extension

Email Address *

Section 3: Service Specific Information

Service

Funds Service
Securities Service
National Settlement Service

Section 4: Test Environment Location

(Check only one)

Production Site

Primary Production Site Information

City

State

Last Octet of FRB Assigned IP Address

(i.e. X.X.X.123)

Alternate Site

Alternate Production Site Information

City

State

Date of Last Test at Alternate Site

Last Octet of FRB Assigned IP Address

(i.e. X.X.X.123)

Confirm Your Expected Post-BRT Site Information

City

State

Last Octet of FRB Assigned IP Address

(i.e. X.X.X.123)

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Fedwire® Contingency Test Registration Form

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Fedwire^® Contingency Test Registration Form