Macquarie Credit Union Limited ABN 85 087 650 253 AFSL 241132 BSB 802 126
Cheque Stop Payment Notice MEMBER CHEQUE MEMBER/S NAME: MEMBER NUMBER:
MEMBER CHEQUE DETAILS FIRST SERIAL NUMBER:
LAST SERIAL NUMBER:
AMOUNT:
DATE DRAWN:
MADE PAYABLE TO: REASON FOR STOP: I/We hereby indemnify the Credit Union against any loss or claim that may arise from any cause whatsoever in consequence of the Credit Union stopping payment on this cheque. I/We acknowledge that if the cheque is presented I/we will meet all costs associated with dishonour of the cheque. SIGNED:
PLEASE SIGN HERE
DATE:
SIGNED:
PLEASE SIGN HERE
DATE:
OFFICE USE ONLY MEMBER CHEQUE CC 140 - TO LOAD STOP ACTIONED BY:
CC 90 - TO REDEEM CHEQUE BOOK DATE:
165 Brisbane Street PO Box 1618 Dubbo NSW 2830
T: 1300 885 480 F: 02 6882 6909
[email protected] macquariecu.com.au 11/13
