Stop Payment Request Terms and Conditions

The account holder hereby instructs Frandsen Bank & Trust (“the Financial Institution”) to stop payment on the designated check transaction. The check number and/or amount must be exact for the stop payment to be effective. The stop payment will remain in effect for six (6) months. The account holder agrees to hold the Financial Institution harmless against any and all loss, claims, damages, and costs, including court costs and attorney’s fees, that the Financial Institution may suffer or incur by reason of non-payment of the above transaction if presented prior to withdrawal of these instructions or expiration thereof.

The account holder also understands that it is necessary to provide the correct information related to the transaction and that failure to do so may result in the payment of the designated check. 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 failure of the account holder to furnish any item of information requested above completely, accurately and correctly.

I further state that the check transaction was not originated with fraudulent intent by me or any person acting in concert with me.

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