Artesian City Federal Credit Union

STOP PAYMENT FORM

Name

Street

City

State

Zip

E-mail

Work

Home

Check # to Stop

Payable To

Amount

Account #

Date Written

Disclosure: All items must be accurate or our computer systems will not properly stop payment. You need to print, sign and return this form to create a stop payment that is valid for 180 days

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Signature

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Date

Artesian City Federal Credit Union
P.O.BOX 428
Albany, GA 31702-0428

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