There is no standard form for the letter. I recommend you include the date and amount of the transaction, the name of your member from the ACH record of the transaction, and any utility company account number information you might be able to glean from the ACH record. Ask for a copy of the authorization to be faxes back to you, or, if no such record can be obtained from the Originator, an authorization to make a late return of the debit entry. Include contact information in the signature block in case the ODFI needs to follow up with you.
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John S. Burnett
BankersOnline.com
Fighting for Compliance since 1976
Bankers' Threads User #8