(Old Bank Address)
(Old Bank City, State, Zip)
RE: (Your Name – include all names on the account)
(Your Account Number)
Dear Sir or Madam:
Please close (account number _____________), and forward a cashier’s check representing the
closing balance to my attention at the address listed below.
If this notice is not sufficient to authorize the closure of my account, please forward the correct account
closing form(s) to me.
If you have any questions, please contact me at (phone, email).
Your Name (include all names on the account)
Your City, State, Zip