Office of Accounts Payable - Lost Check Re-issuance Form for Vendors and Parent Refunds

Use this form to request the re-issuance of a check from Ball State University. If you should receive this check after you have completed this affidavit, please return the check to the Office of Accounts Payable. Do not attempt to cash this check as it will no longer be negotiable.

Questions?

Office of Accounts Payable
Administration Building, G04
Ball State University
Muncie, IN 47306
Phone #: 765-285-1327
Fax #: 765-285-1947
Email: ap@bsu.edu

Request Details

Check Number:

Please provide the 8-digit check number that needs re-issued.

Re-issue Method:

ACH (NOT AVAILABLE FOR PARENT REFUNDS)

Mail - Send to Address Below

Cancel Check – Do Not Re-issue

Reason for Cancellation:

Mailing Address:

Vendor Name:

Submitted By:

E-mail Address:

Phone Number:

Affidavit:

I certify that I did not receive, or am not in possession of, the check selected above from Ball State University. I therefore request that payment be stopped on the original check and that a new payment be issued or canceled, depending on my selection above.