Description
Use this form when you need to cancel a contract. This template contains verbiage to stop automatic charges to a bank account or fund. Simply fill out of the relevant blanks and send the letter.
CANCELLATION LETTER
Date _________________________
Dear _________________________,
I am writing to inform you of a change with regard to my automatic payment withdrawal regarding account number _________________________.
Currently my _________________________ payment is automatically withdrawn from my account #
____________________ held at _________________________. The automatic payment withdrawals are made on the ______________ day(s) of the month.
I hereby notify you of the cancellation of the authorization for the above referenced automatic payment withdrawals.
I understand that I need to give you at least two weeks notice prior to the next scheduled transaction.
Therefore, I expect the last automatic payment withdrawal to be dated _____________________.
Thank you for your prompt attention to this request.
(Name of Vendor)
(1st, 15th, other)
(Date of Last Transaction)
(Name of Vendor)
__________________________________
__________________________________
__________________________________
(Name)
(Street Address)
(Telephone Number)
(City, State, Zip)
(Signature)
