Request for Reissue of Missing Accounts Payable Check

This is the standard form used to request the reissue of a missing accounts payable check. Once the form is filled out, it should be delivered or faxed to Financial Services. For assistance with this form, please contact Accounts Payable at 501-916-3318.

Request for Reissue of Missing Accounts Payable Check
Date: The date of the request.
Name: The person attesting that the check was not received.
Check Number: The check number of the missing check.
Check Amount: The amount of the missing check.
Check Date: The date the missing check was issued to the Payee by UA Little Rock.
Payable To: Who the check was issued to.
Address: Where the reissued check should be sent.
Payee’s Signature: A handwritten signature is required.