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IF ACH- Reason for Stop (Choose One)
Revoking Authorization of Recurring Electronic Payments
Revoking a One-Time only Electronic Authorization
Please read the following before submitting:
  • I understand by submitting this electronic Stop Payment form I am agreeing to all the conditions as mentioned below.
  • I will notify the originating company of this stop payment.
  • I understand that the amount I list above must be correct for the stop payment to take effect.
  • I agree to indemnify and hold GLFFCU harmless from all liability, damage, and expense incurred as a result of refusing payment of said check.
  • I understand that this stop payment order expires six months from the date hereof unless I renew it in writing.
  • I understand that GLFFCU will not be liable for paying an item on the day the stop payment is received.
  • I agree to allow GLFFCU to charge my account $20.00 for this stop payment request and acknowledge receipt of a copy of this order if I so request and accept and agree to the terms thereof.
I agree that I have read all information above.* *
Yes, I agree
Thank You