Modèle de document

Terminate a direct debit authorization (bank mail)

This letter terminates a direct debit authorization. You have to send it to your bank.

Your first and last name

your contact details

Your account number

Name and address of bank

À city, the date

Subject: Cancelation of a direct debit authorization

Madam, Sir,

The business (name of creditor) deducts each month (or other periodicity) from my bank account (account no.) the sum of (levy amount - if it is a fixed and regular amount).

Hereby, I kindly ask you to cancel this direct debit as of (date) and for all future direct debits.

Thank you in advance, and please accept, Madam, Sir, the expression of my distinguished consideration.

    For details, please use the practical information sheets :

    J'ai réalisé une démarche administrative

    Je donne mon avis sur Services Publics +. L'administration concernée me répondra.

    Je donne mon avis

    Verified 09 September 2026 - Public Service / (Prime Minister)