REQUEST BANK TO PLACE STOP-PAYMENT ON CHECK

I would like to request that a “stop-payment” be placed on the following check{s}:
CHECK #    AMOUNT    RECIPIENT        DATE        ACCOUNT #

[LIST CHECK NUMBER(S), AMOUNT(S), RECIPIENT(S), DATE(S) AND ACCOUNT NUMBER(S), ex.

12423        $1,203.23    ABC Co.        5/3/98        2132342-23423]
I hereby authorize the service charge to be deducted from my [savings / checking] account, #[CHECKING ACCOUNT NUMBER].
Sincerely,