STOP PAYMENT FORM
Last Name First Name         MI		Union Fidelity FCU 1415 N. Loop West Suite 110 Houston, TX 77008 Fax: (713) 869-0846
Street Address                  City                State          Zip		Cell Home E-mail
Account #		Check Number to Stop
Payable to
Amount		Date Written
Disclosure: You need to sign and return this form to create a stop payment that is valid for 180 days.  Union Fidelity FCU will not be responsible for checks that have already been processed or presented.  A fee of $25 will be charged to your checking account for processing the stop payment request.
_______________________________    Signature	________________    Date
I understand it is my responsibility to update any and all stop payments not the responsibility of my Credit Union.
_______________________________    Signature	________________    Date

You Must Print, Sign, and Return to Credit Union (by mail, fax or in person) A signature is needed to complete the process