Date (ie. July 31, 2000)
BY FAX Bank Name Bank Address Attention: Name of Bank Representative or Manager Dear Sir or Madam: You are hereby requested and instructed to place a “stop-payment” on the following check: Check No.: Amount: Payee: Date: Account No: Check No. Amount of Check Name of Person to whom Check Payable Date of Check Bank Account No. (ie. 12345678)
You are hereby authorized to deduct the service charge from the same account. This shall be your good and sufficient authority for so doing. Yours truly,
Your Name