[REQUESTOR]

[REQUESTOR’S ADDRESS]

[DATE]

[RECIPIENT OF REQUEST]
[ADDRESS]

To whom it may concern:

I am requesting a stop on payments for the in-house financing on my account as the notice of
approval from [FINANCING INSTITUTION] has been granted. As per our arrangements, please
pull out the following checks:

CHECK
DATE NAME AMOUNT
NUMBER

TOTAL:

For the same reason, please provide a refund for the following checks:

CHECK
DATE NAME AMOUNT
NUMBER

TOTAL:

Kindly find attached a copy of the Notice of Approval for your reference.
Thank you for your consideration.

Best regards,
[REQUESTOR]
[REQUESTOR]