Fillable Payroll Stop Pay Req (University of West Florida)

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Payroll Stop Pay Req (University of West Florida)

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UNIVERSITY OF WEST FLORIDA
P
AYROLL CHECK STOP PAYMENT REQUEST
Please complete and return to Payroll in Building 20E or mail to 11000
University Parkway, Attn: Payroll, Building 20E, Pensacola, FL 32514.
Today’s Date: _______________
Check No.: _______________
Check Date: _______________
Amount: $______________
Employee Name: ____________________________________
UWF ID#: _______________
Contact Information: ____________________________________
Reason for Stop Payment: ____________________________________
___________________________________________________________________
I understand a replacement check cannot be issued until the bank confirms stop
payment on this check. If I cash check number__________, I agree to reimburse
The University of West Florida for the amount of the check. If I find check
number__________ I agree to return it to the Payroll Office in Building 20E.
_____________
__________________ ______________________________
Employee Name Employee Signature
FOR PAYROLL USE ONLY
Coastal Bank & Trust Account (Payroll)
Reissue (Select One)
___ Reissue two (2) business days from date bank notified
___ DO NOT REISSUE
Special Instructions (use space below):______________________________________________
______________________________________________________________________________
Stop Payment Approved By: ______________________________ Date: ___________________
Check cleared bank: YES / NO Date Cleared: ____________
Reissued Check Approved By: _____________________________ Date Approved: __________
Reissued Check/DD Number: ______________________________ Date Reissued: ___________
Revised 6/26/2017
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Payroll Stop Pay Req (University of West Florida)

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Completed 19 July 2020

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