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Accounts Payable Cancel/Rewrite and Check Copy Request

   
* Indicates Required Field
Requestor Name:
*
Requestor Phone:
*
Requestor Email:
*
Check Number:
*
Check Amount:
*
Payee Name:
*
Was a Payee Certification (PC) Form completed for this payment?: *
*
Has Check cleared Bank?:
*
 
Instructions on check encashment information
If Yes, do you need a copy of the check?:
*
(Required if the check has cleared the bank)
Reason for Cancel:
*
Does check need to be rewritten to the same vendor?:
*
Does check need to be rewritten to a different vendor?:
*
Explanation: