ALABAMA A&M UNIVERSITY | Patton Hall Room 105 | www.aamu.edu
P: (256) 372-5205 | F: (256) 372-5192 | GENACCTING@AAMU.EDU
Name: ID No. (if applicable):
Phone: Email:
Payee Name:
Payee ID (if known):
Check Date: Check Amt: Check No.:
I have not received this check in the mail. I have provided my current mailing address below.
I have misplaced the check or it has been damaged.
Other reason (provide details):
Requestor Signature Date
Check Data Lists to Check
#:
Returned
D:
Stopped
$
Void
Cleared
Re-establish? Yes No
Confirm check data in Banner.
Conf
irm check does not appear on the
returned, stopped, void, or cleared lists.
Has fee been paid if necessary?
Process Stop Payment via bank.
Attach bank stop confirmation.
Sign below.
Route to Accounts Payable.
Check ACH
Processed by General Accounting Date Processed by Accounts PayableDate
DONOTWRITEBELOWTHISLINE.BUSINESSOFFICEUSEONLY.
III. BANK CANCELLATION:
COMPLETED BY GENERAL ACCOUNTING
IV. BANNER CANCELLATION/REISSUANCE:
COMPLETED BY ACCOUNTS PAYABLE
Check Cancellation Info
I have read and understand the instructions included with this form. I further understand that there is a 12 day processing window for this
request, which includes a check reissuance, if applicable. I understand I must pay the $20 fee, if applicable, before this request is processed.
Notes
* Notify Student Account Services if the check being
cancelled is
related to a student refund from a prior fiscal
year.
* Student Account Services will do a refund cancellation
and a new invoice in the current fiscal year.
COMPTROLLER'S OFFICE
Check Cancellation Request Form
INSTRUCTIONS: Fill out the form in its entirety. If you are completing this form on behalf of the payee, supporting
documents must be attached indicating the payee's wish to have the check cancelled. Allow 12 business days for the
cancellation and reissuance (if applicable). Note: There may be a $20 check cancellation fee.
I. REQUESTOR CONTACT INFO: COMPLETED BY REQUESTOR
II. REASON FOR REQUEST: COMPLETED BY REQUESTOR. CHECK THE APPROPRIATE BOX.
Revised04/17/2019
I:________
