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Fedwire® Securities Service Forms

Use the links below to access the forms and agreements you will need to set up or use Federal Reserve Financial Services. Service and Access Setup provides more details and guidance on the steps required to begin using a new service or to modify current services or access. If you are unable to locate the form you seek, Contact provides a comprehensive list of service and support contacts who can assist you.

Fedwire Services Forms

Information on Fedwire Services Forms
Form Links
Fedwire Services Third Party Service Arrangement
(Operating Circular 6, Appendix C)
The Third Party Service Arrangement form is used by financial institutions to designate another entity to act as its service provider with respect to the Fedwire Funds Service and/or the Fedwire Securities Service.
Form (PDF)
Fedwire Services Application Test Request Form
An essential component of Fedwire Services includes widely available and reliable testing. We operate the Depository Institution Testing (DIT) environment on a daily basis Monday through Saturday. In addition, on selected Saturdays, the production environment is available for customer testing. Complete the form to schedule a test for FedLine Direct, FedPayments Manager, Cover Payments or Statements.
Form (Off-site)
FedLine Direct Message Connectivity Test or Repoint Request Form
This form should be used to request a FedLine Direct Message connectivity test and/or an alternate site processing repoint. The information requested in this form may be obtained in the FedLine Direct Implementation Plan that was provided to your organization when the FedLine Direct connection was established.
Form (PDF)
Fedwire Services Contingency Test Request Form
A two-step process that requires you to validate your organization’s testing eligibility. After entering your ABA, if your organization is eligible to participate, a link will be provided to the registration forms. You must then complete one registration form for each date that you plan to test. Specific testing dates are designated by the Federal Reserve Banks each year and listed on our site.
Form
Fedwire Services Contingency Post Test Survey Form
We encourage participating organizations to provide feedback on their testing experience at the conclusion of Fedwire Services Contingency Tests. The survey will help the Federal Reserve Banks to ensure that we continue to provide the highest level of support during these tests.
Form (Off-site)

Fedwire Securities Services Forms

Information on Fedwire Securities Service Forms
Form Links
Audit Confirmation Request Form
The Audit Confirmation Request Form may be used by financial institutions, their regulators or their auditors to request a copy of a securities holdings statement as of a particular date.
Form (PDF)
Instructions (PDF)
Authorization to Release Information to Accounting Firms (Information Release Form) for electronic Audit Confirmation Requests
Form is required for preferred electronic processing of confirmation requests from Audit Entities, for Fedwire Securities Service holdings statement information through Confirmation.com.
Form (PDF)
Instructions (PDF)
Fedwire Securities Service Authorization Form
The Fedwire Securities Service Authorization Form is used by financial institutions to provide a list of individuals with authority to process offline securities transfers, request copies of transactions or statements, and request changes to the institution’s Fedwire Securities Service profile.
Form (PDF)
Instructions (PDF)
Transaction and Service Fee Settlement Authorization
(Operating Circular 1 - Appendix 2)
The Transaction and Service Fee Settlement Authorization form is used by financial institutions to establish correspondent/respondent relationships for the purpose of settling financial transactions and service charges.
Form (PDF)
Pledgee Agreement and Authorization List & Instructions
(Operating Circular 7 - Appendix C)
The Fedwire Securities Joint Custody Service is designed to assist state and local government entities in mitigating risk to deposits of public funds in excess of Federal Deposit Insurance Corporation (FDIC) insurance limits. The service facilitates the collateralization of deposits made by a government entity, including deposits above the current $250,000 insurance limit, through the pledging of book-entry securities by its depository financial institution.
Form (PDF)
Instructions (PDF)
Joint Custody FedMail Sign-Up Form & Instructions
(Operating Circular 5)
Provides the ability to receive Joint Custody Daily Activity Statements and monthly Securities Holdings Reports electronically. The email is sent in text format; the statements and reports are sent as attachments, which may be viewed with a text editor, spreadsheet or word processing software.
Form and Instructions (PDF)

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