STOP PAYMENT FORM
Last Name
First Name         MI 		Patterson FCU
124 WP Malone
Arkadelphia, AR 71923
Fax: (870) 246-8006
Street Address
                 City 
              State          Zip 		Cell
Home E-mail
Account # Check Number to Stop
Payable to
Amount Date Written
Disclosure: You need to sign and return this form to create a stop payment that is valid for 180 days.  Patterson FCU will not be responsible for checks that have already been processed or presented.  A fee of $25 will be charged to your checking account for processing the stop payment request.

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   Signature
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   Date
I understand it is my responsibility to update any and all stop payments not the responsibility of my Credit Union. 

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   Signature
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   Date
You Must Print, Sign, and Return to Credit Union
(by mail, fax or in person)
A signature is needed to complete the process