止付通知書
DO NOT MAKE A DUPLICATE-IF ANOTHER CHECK IS GIVEN
DRAW A NEW CHECK WITH DIFFERENT DATE AND NUMBER
不要復制原支票，如果要再提款，請重新簽發日期與編號均與原支票不同的新支票
CHICAGO_____________________20_________
芝加哥， 日期：
TO
致：×××銀行
PLEASE STOP PAYMENT OF
請停止支付下列支票
CHECK No．_______________________
支票號碼：
DATE______________________________
簽發日期：
ISSUED to__________________________
收款人：
_______________________________________________________________________________
FOR $______________________________________________________
金額：$
BE CERTAIN TO RE-VERIFY AMOUNT OF STOP PAYMENT WITH CUSTOMER AFTER YOU HAVE RECEIVED ALL INFORMATION．THE AMOUNT MUST BE EXACT．
請貴行收到所有信息后務必與顧客再核對一次止付數額。數額必須準確。
FOR THE FOLLOWING REASON：_________________________________
止付原因：
_______________________________________________________________________________
ACCOUNT NUMBER____________________________________________________________
賬號：
TITLE OF ACCOUNT______________________________________________
賬戶名稱：
_______________________________________________________________________________
BY ______________
AUTHORIZED SIGNATURE
簽發人（或銀行）簽字
ADDRESS ____________________________________________________________________
地址：
PHONE NO _______________________________
電話：
FAX NO ________________________
電話:
___________________________________________ TIME RECEIVED
_______________________________
TO _______________________________________
收件時間： 致：
By ___________________ （注：在□內打×表示選擇）
WILL BOOKKEEPING DEPT.簿記處 □
須 } CONFIRM ___________ UNIT TELLER收付款出納 □
WILL NOT 確認 SPECIAL PAYER特別付款人 □
不須
