Accounts Payable

Stop Payment Request Form

This form is to be used when you are NOT in possession of the check.

If you are in possession of the check, complete the Cancel Check Form and send to Accounts Payable.

[* = required field]

Contact Information

* Department Contact First Name:

* Department Contact Last Name:

* Department Contact E-mail:

* Department Contact Phone Number:

* Department:

Action Requested: Stop Payment and Reissue Stop Payment with No Reissue

Disbursement Information

* Disbursement Number: 

Disbursement Date:

* Disbursement Amount:

Document Number:

* Remit to Payee Name:

* Explanation:

Supplemental content

Accounts Payable