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Request Bank To Place Stop-payment On Check

REQUEST BANK TO PLACE STOP-PAYMENT ON CHECK

[Date]


[NAME, COMPANY AND ADDRESS, ex.
Tom Atkinson
COMANY Bank
14 Edith Street,
Hackney West,
ZIP POST CODE]

Dear [NAME, ex. Tom Atkinson],

I would like to request that a “stop-payment” be placed on the following check{s}:

CHECK # AMOUNT RECIPIENT DATE ACCOUNT #
[LIST CHECK NUMBER(S), AMOUNT(S), RECIPIENT(S), DATE(S) AND ACCOUNT NUMBER(S), ex.
12423 $1,203.23 ABC Co. 5/3/98 2132342-23423]

I hereby authorize the service charge to be deducted from my [savings / checking] account, #[CHECKING ACCOUNT NUMBER].

Sincerely,


[YOUR NAME, ex. Tony Montana]

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