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Kellogg Community Credit Union
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ACH Dispute

Automated Clearing House (ACH) rules state that a Written Statement of Unauthorized Debit must be obtained before an unauthorized debit may be returned.

If this form is submitted to KCCU by mail or through our secure online Send my Docs application from our website, then the form must be signed and stamped by a notary.


Written Statement of Unauthorized Debit


things to know...

  • Please fill out one form for each payee company.

  • Fill out the form as completely and accurately as you can. Incomplete forms cannot be processed and any errors may delay your credit back.

  • Within two business days of receiving your written notice of a disputed transaction, we will place a credit to your KCCU account while we investigate.

  • Your request is subject to the KCCU Electronic Disclosure and Agreements. Please refer to the appropriate document for information on KCCU’s responsibilities and your rights regarding your dispute.  This document is available online at or at any branch location.


3 ways to submit your completed form:

Option 1: Drop it off at any of our branch locations.

Option 2: Mail it to: KCCU, PO Box 140, Battle Creek, MI 49016 – Requires signature and stamp by notary.

Option 3: Submit it through Send My Docs in the Complete Forms area of our website.