Ach Stop Payment Form PDF Details

An ACH Stop Payment form is an official written request that instructs your bank or financial institution to block a specific electronic debit from clearing through the Automated Clearing House (ACH) network. You typically need this form when you discover an unauthorized charge, a duplicate transaction, or a recurring payment you want to cancel. Most banks require the stop payment request at least three business days before the scheduled transfer date, so acting quickly is important.

When Should You Use an ACH Stop Payment Form?

This form is the right tool any time you need to halt an automatic bank withdrawal you did not authorize or no longer want. Common situations include:

What Information Do You Need?

Most ACH stop payment forms require the following details to identify and block the transaction:

Once you submit the completed form, your financial institution will confirm whether the stop payment was successful. Note that most banks charge a fee between $15 and $35 for processing a stop payment request. If you need to set up a new authorized payment arrangement, see our ACH Authorization Form or our ACH Payment Enrollment Form.

QuestionAnswer
Form NameAch Stop Payment Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdocuments netspend com en español, doumementsnetspend, documents at netspend com, documentsatnetspend com

Form Preview Example

 

NetSpend Corp.

 

 

 

 

 

 

PO Box 2136

 

 

 

 

 

 

Austin, TX 78768-2136

 

 

 

 

 

 

Phone: 866-387-7363

ACH STOP PAYMENT FORM

 

Fax: 512-532-8345

 

 

 

 

 

 

Customer Reference Number:

 

 

 

 

 

_ _ _ _ _ _ _ _ _ _

 

Date of Request:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Customer Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Customer Phone Number:

 

 

 

 

EXACT Amount of ACH:

 

 

 

 

 

 

 

 

 

Date of Expected ACH Debit:

 

 

 

Date of Last Payment:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Originating Company Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please select only one:

Stop ALL future payments to this merchant

Stop future payments to this merchant for 1 month

There is a fee charged for each ACH Stop Payment request that is processed. The amount of the fee can be obtained by calling the NetSpend Customer Service Line at 1-866-387-7363.

A separate form will need to be completed for each item.

You are requesting Netspend Corporation to stop an Auto Clearing House (ACH) debit on your account as specified above. If an item is presented and does not exactly match the information you provide on this form it may be paid or returned according to Netspend Corporation policies and procedures. Netspend Corporation's liability shall not, in any event, exceed the amount of the ACH debit. You agree to reimburse Netspend Corporation for any loss it sustains in honoring this request. If you wish to cancel this request it must be received in writing. Please be advised certain ACH items are not allowed to have stop payments placed. Netspend Corporation will not be liable if a stop payment for an ACH item is later determined to be a force paid item. For ACH items, the stops are searched by amount and/or payee (only if the same item has been paid previously). A Stop Payment order must be received at least three banking days before the scheduled date of transfer.

I hereby request Netspend Corporation to stop payment on the above item. All the information provided is accurate. I have read and agree to the terms and conditions of this request. If the item is presented in a different method than I have indicated, the item may still be paid with no liability to Netspend Corporation. I understand if I DO NOT sign and return this form within 14 calendar days, my stop payment will expire on the 14th day of the initial request. I will not be refunded any fees and I will not hold Netspend Corporation liable for payment of this item. If I still want the item stopped I will need to complete a new request, and an additional service fee will be assessed to my account.

Netspend Corporation and the undersigned agree to abide by the ACH rules and regulations regarding Stop-Payment orders.

Customer Signature _________________________________________________ Date _________________________

NOTICE

If you wish to release the Stop-Payment Order described above, please sign below and return this form to NetSpend Corporation so we may remove the Stop-Payment Order from our records.

The Stop-Payment Order above hereof is released

Customer Signature _________________________________________________ Date _________________________

Release should bear same authorized customer signature as original Stop Order.

Internal Use Only

Received By: _______________________ Date: ________

Processed By: _______________________

Date: ________

Fee Charged By: ______________________ Date: ________

Audited By: _______________________

Date: ________

Terms

Automated Clearing House (ACH) - The ACH Network is a nationwide batch-oriented electronic funds transfer system governed by the NACHA OPERATING RULES which provide for the interbank clearing of electronic payments for participating depository financial institutions. The Federal Reserve and Electronic Payments Network act as ACH Operators, central clearing facilities through which financial institutions transmit or receive ACH entries.

ACH payments include, but are not limited to:

*Direct Deposit of payroll, Social Security and other government benefits, and tax refunds; *Direct Payment of consumer bills such as loans, utility bills and insurance premiums; *Business-to-business payments;

*E-commerce payments;

*Federal, state and local tax payments

Customer Name - Name listed on the ACH and the name should appear on the NetSpend account.

Customer Reference Number - This is a number obtained from Netspend and is used to locate your account on their system.

Date of Request - Date customer completed form.

Originating Company Name - Name of company sending the ACH to Netspend. Any individual, corporation or other entity that initiates entries into the Automated Clearing House (ACH) Network.

Written Statement of Unauthorized Debit (WSUD) form - A sworn Statement by a customer declaring that a particular ACH transaction was unauthorized, improper or that authorization for the transaction has been revoked.

Frequently Asked Questions

What happens if the ACH is not stopped in time or shows up on my account?

If the ACH appears on your account, please fill out a WSUPP form. The form may be obtained by calling the NetSpend Customer Service Line at 1-86-NETSPEND (1-866-387-7363).

Will I still be charged a fee for the Stop Payment request if the ACH is not stopped?

Yes. The fee is intended to pay for the processing of the form. This is not a guarantee that the payment will be stopped. NetSpend

will take reasonable measures to ensure that the payment does not post to the account.

When will the Stop Payment fee be removed from my account?

The Stop Payment fee will be obtained when you first communicate to NetSpend your request to stop a payment.

Can I stop payment on any ACH?

Yes. Simply notify NetSpend, either orally or in writing, at least three business days before the scheduled payment date. If you call NetSpend, you may also be required to provide a written request within 14 days. As a courtesy, you may also want to inform the Originating Company that you are stopping a payment. Keep in mind this only stops one payment, until the request is received in writing. If you want to revoke your authorization for all future payments, you need to contact the Originating Company.

Can I stop multiple payments from multiple companies with one form?

No. Due to record keeping purposes, you must fill out one form for each merchant and/or dollar amount. A Stop Payment fee will be assessed for each request.

How to Edit Ach Stop Payment Form Online for Free

Completing your ACH Stop Payment form is straightforward with FormsPal's free PDF editor. Follow these steps to fill out and save your form.

Step 1: Click the orange "Get Form Now" button at the top of this page to open the form in the editor.

Step 2: Once the form opens, the toolbar at the top gives you tools to add text, check boxes, and signatures. The editor highlights all fillable areas so you can move through the form quickly.

The main sections you will fill in include:

ACH stop payment form fields - Netspend stop payment sections to fill out

Enter your details in the Netspend Corporation section, including your customer reference number, the exact ACH amount, the expected debit date, and the originating company name. Add your customer signature and date in the designated field. If you want to release the stop payment order later, complete the second signature block on the same page.

ACH stop payment form step 2 - entering account and transaction details

Step 3: Review every field carefully before finishing. Pay close attention to the payment amount, the transfer date, and the originating company name. Errors in these fields can cause the stop payment request to be rejected by your bank.

Step 4: When you are done, click "Done" to save your completed form. You can download the PDF, print it directly, or save a copy for your records. FormsPal does not store or share your personal data.

Frequently Asked Questions About ACH Stop Payments

How much does filing an ACH stop payment cost?
Fees vary by institution, but most banks charge between $15 and $35 per stop payment request. Contact your bank's customer service line to confirm the exact fee before submitting.

How long does an ACH stop payment order last?
Most stop payment orders remain active for six months. After that period, the bank may allow the original ACH debit to resume. To permanently stop a recurring payment, notify the originating company directly in addition to filing this form.

Can I stop a payment that has already processed?
A stop payment order only prevents a future or pending transaction. Once an ACH debit has settled in your account, you will need to dispute the charge through your bank's error resolution process instead of filing a stop payment form.

What related forms might I need?
If you need to authorize a new recurring ACH payment, use our ACH Authorization Form. To enroll in ACH payments for the first time, see our ACH Payment Enrollment Form. For a formal written notice confirming a stopped payment, use our Stop Payment Notice.

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