Date:

To (Company):

Address:

City, State, Zip:



Re: Change of Instructions for Automatic Payments

Dear Sir or Madam:

I have recently changed banks and will need to have my automatic payment switched immediately 
from my old account to my new account with ACME Bank. My information is below:


	Billing Account Number:



I currently have my automatic payment coming out of the following account:

	Financial Institution:

	Account Number:

	Bank Routing Number:



I would like this redirected to my new ACME Bank account as soon as possible:

	Type of account (checking or savings):

	Account Number:

	Bank Routing Number:



If you need any additional information, please call me at:


Thank you.

Sincerely,


__________________________________________________
Signature

	Name:

	Address:

	City, State, Zip:


Enclosed: Voided check from my new ACME Bank account