Church Street Station

Church Street Station P.O. Box 3205 - New York, NY 10007 (212) 693-4900 MUNICIPAL CREDIT UNION ACH Stop Payment Request / Cancellation Please complete. sign and return this form to either request or cancel a stop payment of an electronic (ACH) payment transaction. If you were provided with a pre-addressed envelope with this form, please use it to expedite delivery. You can also fax the completed request form to (212) 416.7304. If you requested a stop payment verbally, please be aware of the following: A stop payment request is effective for fourteen (14) calendar days only unless a written request. signed by the account owner and meeting MCU specifications, is received. If a written request, signed by the account owner and including all required information, is not received by MCU within 14 calendar days, your verbal stop payment request will cease to be binding and MCU may honor subsequent debits to your account. Member Name Account No Brooklyn NY 11207-1012 Address