Payment Transfer Request
Fill Out Form, Print and Provide to Vendor.


Dear

I am writing to inform you of a change in my banking relationship concerning my account number .

I currently have my payment automatically withdrawn from my checking/savings account # at on the of the month. I would like to transfer these monthly transactions to my new financial institution, POWERCO Credit Union, and submit this letter as written notification of that intention.

I understand I need to give you several days/weeks notice prior to the next scheduled transaction. Therefore, I expect the last transaction from to be the one dated and the first one from POWERCO Credit Union to be dated . Thank you for your prompt attention to this request. I have enclosed an automatic payment authorization form that includes the information necessary for you to begin withdrawals from my POWERCO Credit Union account.

Sincerely,




enclosure