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Org ACH STOP PAYMENT ORDER FORM Member Name Account Number Share ID Stop Payment Type Choose One Single ACH Stop All ACH Stop Company I. 14040 Central Loop Woodbridge VA 22193 703. 730. 1800 1. 888. 503. 2328 Fax 703. 730. 1410 www. belvoircreditunion*org contactcenter belvoirfcu. D. Number Stop ACH Type Choose One Stop Debits Only Stop Debits and Credits Default Name of Company Amount of Electronic Item Expected Withdrawal Date Reason for Stop SINGLE ACH STOP PAYMENT WILL STOP THE FIRST TRANSACTION* ALL ACH STOP PAYMENT WILL STOP ALL TRANSACTIONS INDEFINATELY. A fee of 30 is charged for each stop payment. This fee has been deducted from your account. Members Signature Date CU Use Request Taken By BFCU Employee Teller No* Date Accounting. D. Number Stop ACH Type Choose One Stop Debits Only Stop Debits and Credits Default Name of Company Amount of Electronic Item Expected Withdrawal Date Reason for Stop SINGLE ACH STOP PAYMENT WILL STOP THE FIRST TRANSACTION* ALL ACH STOP PAYMENT WILL STOP ALL TRANSACTIONS INDEFINATELY. A fee of 30 is charged for each stop payment. This fee has been deducted from your account. Members Signature Date CU Use Request Taken By BFCU Employee Teller No* Date Accounting.

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