Stop Payment Request

To request us to stop check payment(s), please fill out this form and submit it to Bluestem (This is a secure form).
Alternatively, the page can be printed and mailed to Bluestem Bank, 104 East Locust, Fairbury, IL 61739.

Name:
Address:
City, State Zip: ,
Phone: Home: Business:
Account Number:


Date of Check Check Number Amount of Check Payable To

Additional Comments or Instructions:


We will process your request to Stop Payment on the check(s) described above, unless we have already paid, certified or accepted it. Your request will cease to be effective six months from the date shown above. Bluestem Bank will not be liable for payment of the check contrary to this request unless payment is caused by Bluestem Bank's negligence and causes actual loss to you. Bluestem Bank's liability shall not, in any event, exceed the amount of the check. You must reimburse Bluestem Bank for any loss it sustains in honoring this request.

Bluestem Bank will charge a stop payment fee based on the fee schedule you have already received.