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Chessie written statement sample 2026

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The document is a Written Statement of Unauthorized Debit (ACH) for Chessie Federal Credit Union, where the account holder attests that a specific electronic debit to their account was not authorized. It outlines the necessary information regarding the debit, reasons for disputing it, and includes a section for the account holder's signature and acknowledgment by the credit union.

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Click ‘Get Form’ to open the chessie written statement sample in the editor.
Begin by filling in the 'Account/Transaction Information' section. Enter your name, account number, amount of debit, date of debit, and the party debiting your account.
In the 'Statement' section, select the appropriate reason for disputing the debit. You can choose from options such as not authorizing the debit or revoking authorization prior to the transaction.
Proceed to sign and date the form in the 'Signature' section. Ensure that you confirm your authority over the account and attest that all information is accurate.
Finally, review all entered information for accuracy before submitting. Utilize our platform’s features to save or share your completed document as needed.

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