Louisiana State University
Office of Accounting Services
Financial Accounting & Reporting
204 Thomas Boyd Hall
204 Thomas Boyd Hall • Baton Rouge, LA 70803 • P 225-578-3321 • F 225-578-7217
STOP PAYMENT/ CANCELLATION REQUEST FOR CHECK PAYMENTS AS32
Request Date ______________________
Stop payment Cancel (if original check is attached)
* I certify that I accept financial responsibility for all costs incurred if this check is deposited after the stop payment has
been placed. In the event I receive this check, I will return it to LSU, Office of Accounting Services, 204 Thomas Boyd
Hall, Baton Rouge, LA 70803.
All reissued PAYROLL CHECKS are subject to a $25 stop payment fee. The fee will be deducted from the next payroll
check. If you are currently enrolled or decide to enroll in Direct Deposit, the fee will be waived.
______________________________________ ____________________________ __________________
* Signature of Payee (Required for Stop Payment) LSUID or Vendor # Date
Reason ___ Did not receive check ___ Misplaced check
___ Damaged check ___ Duplicate payment
___ Incorrect amount ___ Incorrect vendor/payee
___ Other _________________________________________________________
Action ___ Do not reissue
___ Reissue ___ Contact me at __________________________ or
___ Mail the check to:
Name ______________________________________________
Address ____________________________________________
City _________________________ State _____ Zip _________
Reissue via Electronic Payment (if applicable)
FOR ACCOUNTING SERVICES USE ONLY
Replacement checks should be coded SPH to FAR – Bank Recon
