Star One Credit Union
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Star One Credit Union ACH Stop Payment Form

ACH STOP PAYMENT ORDER

Not to be completed for Debit Card, Credit Card, or Bill Pay transactions. 

Please complete the entire form.  Incomplete forms may not be processed in a timely manner.  Then print, sign and mail or deliver to Star One Credit Union, PO Box 3643, Sunnyvale, CA, 94088-3643.

Date of Request:
Member Name:
Member Number: Checking:  Savings:
Daytime Telephone Number:
Select One Option: One Time Stop OR Permanent Stop

____________________

Select One Option:

Any Amount OR

 
Amount of: $
Company Name:
 

Must match the description exactly as shown on your statement.

Please stop payment on the electronic debit described above, unless you have already paid or accepted it. I understand this ACH Stop Payment request will remain indefinitely, unless it is subsequently canceled in writing by me and it must be received by the Credit Union at least (3) three business days before the scheduled date of transfer in order to be effective. The Credit Union may accept a stop payment order after that time, but will not bear any liability if it does not act on the order. The Credit Union will not be liable for payment of an electronic debit 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 electronic debit. I agree to reimburse the Credit Union for any loss it sustains in honoring this request.

I authorize a fee of $13.00 to be charged to the account referenced above for a one-time Stop-Payment.

______________________________________________ _________________
Authorized Signature Date

Star One Credit Union Use Only
Received by (Operator ID & Initials): ________________________/_______________
Date: __________________________
Fee Charged     Fee Waived

Rev: 12/28/2012

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