Main Content VISA Preauthorized Recurring Payment Cancellation Options Add Delete Change Preferred Method of Contact * Written Phone Account Number * Full Name * Payable To * Last 4 Digits of the VISA Card * Expected Clearing Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20182019202020212022 Transaction Amount * $ AgreementAs of the above date, I hereby notify Topside Federal Credit Union to terminate the preauthorized recurring Visa payment listed below: Three (3) banking days advance notice prior to the expected transfer date of the debit entry is required to implement the stop payment request. If the stop payment order is received within three (3) banking days of the expected transfer date, the Topside FCU will attempt to satisfy the request of the account holder, but will not be held liable if sufficient time was not provided. Criteria * Revoke all future payments to the indicated merchant. * Stop exact dollar amount indicated above only.** DisclosuresThe account holder also understands that it is necessary to provide the correct information related to the transaction, and that a failure to do so may result in the payment of the above item. The account holder agrees to hold harmless and indemnify the financial institution for all expenses, costs, and damages incurred by payment of the above item if such payment is the result of the failure of the account holder to meet the time requirements noted above, or if such payments is the result of failure of the account holder to furnish any item of information requested above completely, accurately, and correctly. A charge of $29.00 will be assessed to the account holder as payment for the implementing this order: I further depose and say that the debit transaction described above was not originated with fraudulent intent by me or any person acting in concert with me, and that the signature below is my own proper signature, I certify under penalty of perjury that the foregoing is true and correct. This stop/revocation order does not release you from the obligation to pay for goods and services purchased from merchants. Signature * Date of Completion Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20182019202020212022 Leave this field blank CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.