Direct Debit Cancellation Letter Sample

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					No. 10 – Instruction to cancel a direct debit authorisation

Use this sample letter to instruct your bank or financial institution to cancel a direct debit authorisation.

This sample letter is for information only and should not be relied upon as legal advice. The information
applies only in Victoria, and was updated on 16 September 2009.

[Date]                                                                               [Your street]
                                                                                     [Your suburb and postcode]
                                                                                     [Your phone number]

[Street number and name]
[Suburb and postcode]

Dear [ ],

Subject: Instruction to cancel direct debit authority
           Name: [Your Name]                              Account Reference No. [your number]

I am writing to instruct you that I hereby cancel and withdraw any previous authority I have granted the
bank to make direct debit transactions in relation to my bank account number [xxxx xxxxx].

At present you are authorised to make the following direct debits from my account:

Payee                       Amount                       Frequency                    Next due date

Lifestyle gym               $40                          monthly                      day month year

AGL electricity             (full amount of account)     as issued by AGL             not known

Health insurance            $ 1600                       Annually                     30 June 2010

My instructions are now that, in accordance with the Code of Banking Practice, you cancel all of the
above direct debits immediately on receipt of this letter, and any other claims for direct debit payment
from my account.

I shall be advising all of the above payees that I have cancelled my direct debit authority and I will not
accept responsibility for direct debits or any fees or charges as a result of direct debit activity in my

Please give this matter your earliest attention, and advise me in writing when you have carried out this
cancellation instruction.

Your faithfully,

[your name and signature]

Description: Direct Debit Cancellation Letter Sample document sample