Ach Stop Payment Form PDF Details

Did you know that you can stop a payment on a check before it clears? This form, called an Ach Stop Payment Form, authorizes your financial institution to stop the payment on a specific check. Use this form if you have already issued the check and want to stop it from being cashed. Be sure to provide all of the necessary information so that your financial institution can successfully process the request. Remember, there is usually a fee associated with stopping a payment, so be sure to factor that into your decision. For more information on how to use this form or other aspects of banking, be sure to consult with your financial institution.

You will find information regarding the type of form you would like to fill out in the table. It can show you the time you'll need to fill out ach stop payment form, what fields you will need to fill in, etc.

Form NameAch Stop Payment Form
Form Length2 pages
Fillable fields12
Avg. time to fill out2 min 58 sec
Other namesdocuments netspend com activate, document netspend com, netspend documents, documents netspend com en español

Form Preview Example


NetSpend Corp.







PO Box 2136







Austin, TX 78768-2136







Phone: 866-387-7363



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 _________________________


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: ________


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

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documents netspend com empty fields to fill out

Inside the field You are requesting Net, spend If you wish to release the, NOTICE, The Stop, Payment Order above, Customer Signature Date , Release should bear same, Received By: Date: Processed By:, Fee Charged By: Date: Audited, and Internal Use Only enter the particulars which the program requests you to do.

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