I am writing to inform you of a change with regard to my automatic payment

withdrawal regarding account number ____

Currently my ___ payment is automatically withdrawn from my acc # ____ held at
____ . The automatic payment withdrawals are made on the ___ days of the
month

I hereby notify you of the cancellation of the authorization for the above
referenced automatic payment withdrawals

I undertand that I need to give you at least two weeks notice prior to the next
scheduled transaction.

Therefore, I expect the last automatic payment withdrawal to be dated___

Thank you for your prompt attention to this request.

NAME OF VENDER
DATE OF LAST TRANSACTION

[Your address]
[Bank/building society address]
Dear
[Reference: Cancellation of a direct debit]
Account number: [xx]
Sort code: [xx]

Company name: [name of organisation taking the Direct Debit]

Reference: [insert the Direct Debit reference from your bank statement]
Amount: [if known, or variable]
Date: [eg 1st of the month]
Please cancel the Direct Debit Instruction detailed above effective from [insert
date].
I have copied this letter to [insert organisation name] for their information.
Yours faithfully