STOP PAYMENT / REISSUE REQUEST
TO: EL PASO CONSOLIDATED TAX OFFICE
WELLS FARGO PLAZA, THIRD FLOOR
221 N KANSAS STREET, SUITE 300
EL PASO, TEXAS 79901; PH (915) 212-0106, FAX (915) 212-0108
FROM:
Requestor Printed Name
Phone Number OR Email address
RE: PID #: CHECK#: AMOUNT:
PAYEE: ISSUE DATE:
ACTION: (PLEASE CHECK ACTION TO BE TAKEN)
VOID ONLY VOID & REISSUE
VOID & TRANSFER TRANSFER TO:
(IF NAME AND/OR MAILING ADDRESS IS DIFFERENT FROM ORIGINAL CHECK, COMPLETE THE FOLLOWING INFORMATION)
Name(s):
Address:
Address:
City: State: Zip:
REASON: (PLEASE CHECK REASON)
Stale Date (Past 90 days from issue date) Incorrect Amount
Never Received Incorrect Address
Lost By Payee Erroneous Refund
Wrong Payee (Must provide Proof of Payment)
Other -
_____________________________________ ________________________
Requestor Signature Date
* Any person knowingly submitting false entries is subject to: (1) Imprisonment of 2 to 10 years or $5,000.00 fine, or both. (2) Imprisonment up to one year,
or fine not over $2,000, or both. (Section 37.10 Penal Code) *
