Escrow Disbursement Request

Escrow Disbursement Request — Form Fields

This finance template includes 8 fields. Request the release of funds held in escrow upon fulfillment of agreed conditions. Provide transaction details, disbursement instructions, and supporting documentation for review. Free to customize and use on ZenBuild.

• Escrow Account Number (text, required)
• Requestor Name (text, required)
• Disbursement Amount Requested ($) (number, required)
• Disbursement Reason (dropdown selection, required) — options: Transaction Close / Settlement, Milestone Completion, Dispute Resolution, Refund to Buyer, Release to Seller
• Recipient Bank Account (Last 4 digits) (text, required)
• Disbursement Method (multiple choice, required) — options: ACH / Bank Transfer, Wire Transfer, Check
• Supporting Documentation (file upload, optional)
• Conditions Met / Justification (long text, required)