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You must fill in this form completely. Requests received by 2 pm central time will be processed on the same business day excluding holidays.



Account Number

Draft Date

Account Number


Pin Number

Draft Number

Draft Amount

Payable To

Please stop payment on the draft described above, unless you have already paid, certified or accepted it. I understand that this written request will cease to be effective six (6) months from todays date. The Credit Union will not be liable for payment of the draft contrary to this request unless payment is caused by the Credit Union's negligence and causes actual loss to me. The Credit Union's liability shall not, in any event, exceed the amount of the draft. I agree to reimburse the Credit Union for any loss it sustains in honoring this request.

By submitting this request I agree to the above terms.




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