You can print this and give it to your bank.
Please instruct your bank to wire the sum of ______ to The Bank of New York, SWIFT IRVTUS3N / ABA No. 021000018 for credit to Scotiabank de Costa Rica S.A. account No. 8033383577 and final credit to the account No. 3001090228 of James O. Grabbe.
Please also instruct your bank to send a SWIFT message MT103 as follows:
56A: Intermediary-BIC
IRVTUS3N
BANK OF NEW YORK
NEW YORK, NY US
57A: Account With Institution-BIC
/8033383577
NOSCCRSJ
Scotiabank de Costa Rica S.A.
SAN JOSE CR
59: Beneficiary Customer
/120-1-3001090228
James O. Grabbe
SAN JOSE, COSTA RICA