Your nameAddress 1Address 2Address 3Postcode City,State

ManagerBank branch’s nameAddress 1Address 2Address 3Postcode City,State

Date: 24 April 2012

Dear Sir/Madam,

CANCELLATION OF DIRECT DEBIT

Please cancel the direct debit Instruction detailed below with effect from DDMMYY.

Account number: 012123456789I.C./passport number: 880808-08-8888Originator Name: (name of organisation collecting the direct debit)Originator Number: (if known)Reference: (Insert the Direct Debit narrative from your bank statement)Amount: RM 8,888.88 /month.Due Date of direct debit: 27 May 2012

This cancellation of auto transfer has been agreed by the originator.

Yours truly,

_____________Your name(I.C./Passport Number)