Get Form 13287
Yer identification number (FEIN) of bank 3. Bank branch street address 4. Branch number of bank where problem occurred 6. American Banking Association (ABA) 5. City, State, ZIP Code number 8. Telephone number ( ) 7. Bank contact name and title (Please print) 9. FAX number ( ) 10. Number of payments delayed 11. Payment / Combined payments amount 12. Type of payment ( x proper box) $ 13. Date t/p requested payment (mmddyyyy) ACH debit ACH credit 14. Date pyt transmitted (mmddyyy.
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