Stop Payment Request

Stuff happens

Sometimes you need to stop a check or an electronic debit before they process…we understand. If they’re not consecutive numbers, simply submit the form as many times as needed. You will incur a stop payment fee of $20 +tax (per item), which will be taken from your account, if you do not have the funds to cover this fee, we cannot stop any payment(s).

This form is good for a one time stop within 14 calendar days. If you need something beyond 14 days, please call us at (563) 264-7210.

Please note: There is NO way to stop a debit card transaction, the form below is ONLY for checks and electronic debit payments. If you have a disputed transaction that has already cleared, do NOT use the form below as it will not work. You will have to contact us to fill out an unauthorized ACH debit form.

Full Name*
First Last
Member #*
Email Address*
Are You Stopping a Check or an ACH?
- Check
- ACH
Starting Check Number*

Reference the check number digits at the bottom of the check and not the ones in the upper-righthand corner.
Ending Check Number*

Reference the check number digits at the bottom of the check and not the ones in the upper-righthand corner.
Date Written*
MM slash DD slash YYYY
Signer
Written Out To*
The Amount*
Reason For Stopping*
Just for fun - What’s your least favorite household chore?
Comments
Last 4 Digits of your Social Security Number (SSN)*
By entering your name and last four digits of your social security number in the form above, you are agreeing to sign and submit your stop payment request electronically. Your checking account will be charged a fee of $20 +tax for each item you request a stop payment on; if you do not have the funds to cover this fee, we cannot stop the payment(s).