Stop Payment Request Form

This application is for members who want to stop a payment that has been made from his or her account.

If we have your current email address in our files, you may simply fill out this form to change your address and click, “Submit.”

If we do not have your email address in our records, we will need for you to print and sign this form and return it to the credit union: by fax, mail, or bring it in to a branch. This is a secure form.

Please enter all information in the application form below.

lock This is a secure application.

  • You are hereby authorized to stop payment on the following check:

  • Important: If you need to place a stop payment on more than one check, you will need to fill out this form for each stop payment request.

    In asking this courtesy the undersigned agrees to hold Day Air Credit Union harmless for the said amount and for all expenses and costs incurred by it on account of refusing payment of said check, and further agrees not to hold said institution liable on account of payment contrary to this request if made through inadvertence or accident. Please verify the dollar amount entered above and notify us immediately if incorrect. If a duplicate check is issued or if the original check is returned, the undersigned agrees to notify this institution promptly.

    Uniform code provides that a written stop payment order is binding upon an institution for only 6 months unless renewed in writing and that an oral stop payment order is effective for only 14 days unless confirmed in writing within that period.