Departmental Request to Cancel a Check

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The purpose of this Departmental Request to Cancel a Check form is to request for a paycheck to be stopped in order to avoid overpayment to an employee.

Please complete the following:

Inform the employee that their payment will be delayed or cancelled.
Inform the employee that their payment will be corrected and released only when the required processing has been completed and the job records have been updated.

Please don't fill out this input box.

Date*

Department Name*

Department Head Email*

Requestor's Name*

EMPLID*

Requestor's Title*

Check Number*

Phone Number*

Date of Paycheck to Stop*

Employee's EMPLID*

Employee's Name*

Pay Period Start

Pay Period End

Reason for Request