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Written Statement of Unauthorized ACH Debit Clearly print in blue or black ink. Carefully read all instructions. You will complete both sections 1 and 2. Fully complete the sections before submitting.
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How to fill out affidavit of unauthorized ach

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How to fill out affidavit of unauthorized ach

01
Obtain a copy of the affidavit of unauthorized ACH form from your bank or financial institution.
02
Fill in your personal information, such as your name, address, and account number.
03
Describe the unauthorized ACH transaction in detail, including the date, amount, and recipient or payee.
04
Provide any supporting documentation that you have, such as copies of emails, receipts, or bank statements.
05
Sign and date the affidavit.
06
Submit the completed affidavit to your bank or financial institution either in person or through their designated channel.

Who needs affidavit of unauthorized ach?

01
Anyone who has experienced an unauthorized ACH transaction in their bank account may need an affidavit of unauthorized ACH. This includes individuals who have discovered fraudulent charges, unauthorized withdrawals, or any other unauthorized electronic transaction in their account.
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