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Request for Stop Payment of Check Form

Complete the form fields below to generate a Request for Stop Payment of Check letter that you can send to your bank, should the need ever arise for you to stop payment on any of your outstanding checks.

Click here for completed sample. Bolded items are examples of completed fields from this form.

Your Name:
(Your name as it appears on your checks)
Your Street Address:
(Your street address as it appears on your checks)
City:
(Your city as it appears on your checks)
*State or Province:
(Select a state or Canadian province)
*Zip/Postal Code:
*Country:
Your Checking Account No.:
Your Bank:
(e.g., Bank of America, Wells Fargo, etc.)
Attn:
(Name of person or department you are addressing this request to)
Your Bank's Street Address:
City:
State or Province:
(Select a state or Canadian province)
*Zip/Postal Code:
*Country:
Information on Check You Want the Stop Payment
Payee:
(Name of person or entity to whom you wrote the check)
Check Number:
(Check number of the check on which you want to stop payment)
Check Amount:
(The amount of money you wrote the check)
Date on Check:
(The date on which you issued the check)

This is not a substitute for legal advice and it is suggested that an attorney be consulted.