[Your Name] [Your Address] [City, State, ZIP Code] [Email Address] [Phone Number] [Date] [Payee's Name] [Payee's Address] [City, State, ZIP Code] Subject: Cancellation of Direct Debit Authorization Dear [Payee's Name], I am writing to formally request the cancellation of the direct debit authorization that I have previously granted to [Payee's Name] for processing payments from my [Bank Name] account ending in [Last Four Digits of Account Number]. Due to a change in my financial circumstances, I am no longer able to continue this direct debit arrangement. Therefore, I kindly request that you cease all future direct debits from my account as of [Cancellation Date], ensuring that no further deductions are made. To ensure a smooth transition, please provide me with a written confirmation of the cancellation and a signed copy of this letter as evidence of my request. You can forward these documents to my address stated above, or alternatively, send them via email to [Email Address]. Please note that although the direct debit authorization is being canceled, I am still responsible for fulfilling any outstanding payment obligations to [Payee's Name]. Therefore, I kindly request that you provide an alternative payment method or arrange for the remaining payments to be made by another means. Moreover, I would like to express my gratitude for the services provided by [Payee's Name] thus far. Although circumstances have led to this cancellation, I hold no grievances and sincerely appreciate your cooperation in this matter. If you require any additional information or documentation, please do not hesitate to contact me at [Phone Number] or via email at [Email Address]. I would be more than happy to assist you with any queries or provide any necessary information to facilitate the cancellation process. Thank you for your attention to this matter. I hope for a swift resolution of the cancellation and appreciate your cooperation throughout the process. Yours sincerely, [Your Name]
Para su conveniencia, debajo del texto en español le brindamos la versión completa de este formulario en inglés. For your convenience, the complete English version of this form is attached below the Spanish version.