Enter the check number of the check to be canceled. Only one check per form
Enter the check date as it appears on the check
Enter the total amount of the issued check to be canceled
Enter to whom the check was made payable
Enter the address of the payee as it appears on the check
Provide a reason why the check is to be canceled
Enter the person's name requesting the check to be canceled
Enter the Requestor's department name
Enter the Requestor's email address
Enter the Requestor's telephone number
Cost Object Table - This table has seven columns with one header row and three data rows. The table is for the distribution of charges from the request for payment that was originally submitted
Enter the document number as it appears on check
Enter the department number
Select the appropriate Cost Object type from drop-down list. If completing the form by hand, provide the Cost Object type in the space below the table
Enter the Cost Object number
Enter the Cost Object name
Enter the GL account number
Enter the amount charged to this Cost Object
The Requestor must provide either a hand-written signature or their digital ID. If a hand-written signature is provided, enter the date the form is signed. If a digital ID provided skip the date field
