Please complete, print, sign and submit this form to the appropriate financial institution.

Date
Bank's Name
Address
City, State Zip ,
 
To Whom it May Concern:
Please close the accounts listed below:
Checking #
Savings #
CD # Close Now  or  Close at Maturity
Other #
 

Send a check for the remaining balance(s) to Sterling Savings Bank

Address
City, State Zip ,
Sterling Account #
 

If you have any questions regarding this request, please contact me during the:
Day  or  Evening: at:

Phone (Area Code, Phone #)   
 
Thank you, Sincerely
Signature (please print form and sign here)
Name
Co-Signer Name (please print form and sign here, if applicable)
Co-Signer Name
Address
City, State Zip ,