Cheque Withdrawal Letter - Google

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The following document needs to be completed by the beneficiary of a lost/stolen cheque payable in France in order to pl
Cheque Withdrawal Letter

Lettre de désistement sur un chèque

- The following document needs to be completed by the beneficiary of a lost/stolen cheque payable in France in order to place a stop on this cheque.

Address / Adresse: Citibank File Reference:

I, undersigned,

, beneficiary of Citibank cheque number issued the __/__/____, residing at the above address, for the sum of

. The aforementioned cheque will be stopped following

.(Reason for stop)

I declare purely and simply, to withdraw all of my rights to the funds of this cheque and renounce all and any appeals against * concerning these funds as a result of stoppage. I confirm that I have not endorsed the aforementioned cheque and will return the cheque, should I subsequently receive it

.* Date: Signature: