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Stop Payment Request Order
Please use this form to place a stop payment on your account. This form will be used for both checks and ACH electronic items.
The "Stop Payment Request Order" form cannot be used to dispute an electronic transaction. To dispute an electronic transaction, please complete the "Written Statement of Unauthorized Debit" form.
To speed the processing of your application, please follow these steps:
- Complete the Stop Payment form in full.
- Send your completed form to DCU by:
- Faxing your form to the Electronic Services Fax Line: 508.772.
OR
- Mail your completed form to:
Digital Federal Credit Union Attn: Electronic Services Dept. 220 Donald Lynch Boulevard PO Box 9130 Marlborough, MA 01752-
What you can expect
If you fax your completed form to us or bring the completed form to a DCU branch office, we’ll process your request within 48 hours of receipt.
If you mail your completed form to us without faxing it first, you MUST allow 2 weeks for postal delivery and DCU processing.
Please note that incomplete forms cannot be processed.
STOP PAYMENT REQUEST ORDER
Digital Federal Credit Union • 220 Donald Lynch Blvd PO Box 9130 • Marlborough, MA 01752- 508.263.6700 • 800.328.8798 • dcu.org • [email protected]
Today’s Date ____________ Contact me at _________________________________________________________
Member Name ________________________________ Member Number ________________ Account No. _______
Expected Clearing Date for ACH ______________ Payable To ____________________________________________
Transaction Amount $ ___________ Check(s) No. ____________ Date Check(s) Written _____________________
Reason for Stop Payment ________________________________________________________________________
Please select only one option:
- Stop Payment for Check – Terms and Conditions
q Full-Term Stop Payment.^ On the terms hereinafter set out, the undersigned account holder herby instructs Digital Federal Credit Union, hereinafter called “the Financial Institution”, to stop payment on the above transaction. The stop payment shall remain in effect for 1) six months;
- until written notice is received from the account holder to revoke the stop payment order, whichever occurs first.
- Stop ACH Payment (Consumer) – Terms and Conditions
q One-Time Stop Payment^ - Stop Payment Effective Until:^ ________________________ q Temporary Stop Payment - Stop Payment Effective between^ _________________^ and^ _________________ q Indefinite Stop Payment On the terms hereinafter set out, the undersigned account holder herby instructs Digital Federal Credit Union, hereinafter called “the Financial Institution”, to stop payment on the above transaction. The stop payment shall remain in effect for until written notice is received from the account holder to revoke the stop payment order.
- Stop Payment for Recurring ACH Entries (Consumer has revoked authorization) – Terms and Conditions On the terms hereinafter set out, the undersigned account holder herby instructs Digital Federal Credit Union, hereinafter called “the Financial Institution”, to stop payment on the above transaction. The stop payment shall remain in effect for until written notice is received from the account holder to revoke the stop payment order.
q I authorized __________________________________(company name) to originate one or more ACH entries to debit funds from my account, but on _____________________(mm/dd/yyyy) I revoked this authorization by notifying them in the manner specified in the authorization.
- Stop ACH Payment (Corporate – CCD, CTX, Non-Consumer IAT) – Terms and Conditions
q One-Time Stop Payment^ - Stop Payment Effective Until:^ ________________________ q Full-Term Stop Payment
On the terms hereinafter set out, the undersigned account holder hereby instructs Digital Federal Credit Union, hereinafter called “the Financial Institution”, to stop payment on the above transaction. The stop payment shall remain in effect for 1) six months; 2) until written notice is received from the account holder to revoke the stop payment order, whichever occurs first.
I am requesting that you stop payment on the item described and checked above. I understand that the oral Stop Payment request will expire in fourteen (14) days unless I sign and return this form. By directing DCU to stop payment of this item, I agree to hold DCU harmless against any and all loss, claims, damages, and costs, including court costs and attorney's fees that are incurred as a result of DCU having acted on this Stop Payment Request. Further, I understand that this Stop Payment Request must be received in time to give DCU reasonable time to act on it. If I am requesting that you stop payment on an ACH debit, I understand this request must be received no less than three (3) business days prior to the expected Date.
q If this box is checked, I have asked you to Stop Payment on the Amount rather than the Check Number or ACH Company ID. I understand that you advise against this request and that this will result in the return of any item presented against this account for this dollar amount during the time this Stop Payment Request is in effect.
A $25.00 fee, as disclosed in your Schedule of Fees and Service Charges , will be assessed to my DCU account for processing this Stop Payment Request.
Member Signature: ___________________________________________ Date: ________________________
INTERNAL USE ONLY Processed By # ______________ Date ________________ Fee W/D (Y/N/NA)
M816A 5 .201 9
