Fillable Close Account Request

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Close Account Request

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The Close Account Request form is 2 pages long and contains:

  • 3 signatures
  • 0 check-boxes
  • 15 other fields

Country of origin: US
File type: PDF

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Instructions to Complete the
Notice to Close Account Form
Once all of your items (checks, automatic payments, automatic deposits, etc.) have
cleared your current account, follow the instructions below to close that account at your
current bank.
For checking accounts, keep in mind that some banks charge a fee for disbursing the
funds remaining in the account. To avoid this fee, write a check for the remaining
balance and deposit it into your new American Savings Bank account. Then complete
the attached Notice to Close Account form (“Form”) and present or mail it to the other
bank. Send this Form as soon as all items have cleared to avoid any applicable service
charges.
Instructions:
1. Enter the current bank’s contact information.
2. Enter your personal information (name, address, phone number).
3. Enter the information about your current bank account (indicate the appropriate
type of account and your account number).
4. Print, sign and mail the completed Form to the other bank.
See next page for Form.
Notice to Close Account
To: ___________________________________________
Address: ___________________________________________
City, State, Zip: ___________________________________________
Phone Number: ___________________________________________
From: ___________________________________________
Address: ___________________________________________
City, State, Zip: ___________________________________________
Phone Number: ___________________________________________
To Whom It May Concern:
Effective immediately, please close the following account:
Account Number: ___________________________________________
Account Type:
□ Checking □ Savings □ Money Market Account
Thank you.
Signature: ________________________________ Date: ________________
Signature: ________________________________ Date: ________________
Signature: ________________________________ Date: ________________
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Close Account Request

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Completed 3 July 2020

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