Fillable Stop Payment Request And Indemnification Agreement Form printable pdf download

Stop Payment Request And Indemnification Agreement Form

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333 North Central Avenue • Second Floor • Hartsdale, New York 10530 • Phone: (914) 946-6200 • Fax: (914) 946-2910

Branch Office: 22 West 1st Street • Room 311 • Mt. Vernon, New York 10550 • Phone: (914) 664-2646 • Fax: (914) 664-7991

Stop Payment Request and Indemnification Agreement

AGREEMENT made _________________________ between EDUCATIONAL & GOVERNMENTAL

EMPLOYEES FEDERAL CREDIT UNION and _____________________________________________.

(member)

NOW, THEREFORE, IT IS AGREED between the undersigned as follows:

1. Check number __________was drawn on account number ______________at Credit Union in the amount of

$__________________, dated _______________, made payable to ___________________________________

and was issued to Member at the request of an upon payment from Member.

2. That Member hereby requests Credit Union to issue a stop payment order on the Teller’s check.

3. That in order to induce Credit Union to issue such a stop payment order and in consideration for the Credit

Union’s issuance of a stop payment, Member agrees to save and hold harmless Credit Union, its successors and

assigns, from and against any liability, damage, claim, loss or proceeding made or brought upon Credit Union

which it may suffer as a result of issuing the stop payment on the Teller’s check.

4. That Member shall furnish, upon demand, a bond or other security as Credit Union may deem necessary to

protect the Credit Union’s interest under this Agreement.

5. In the event the Teller’s Check shall hereafter come into the possession of Member, Member agrees to return

the Teller’s Check to Credit Union.

EDUCATIONAL & GOVENMENTAL

EMPLOYEES FEDERAL CREDIT UNION

__________________________

Member Signature

BY:____________________________

___________________________

Print Member Name

Name: __________________________

Title: __________________________

Rev. 2-2013

Stop Payment Request And Indemnification Agreement Form

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