Get Request For Replacement Check

This guide provides step-by-step instructions on how to fill out the Request For Replacement Check form online. By following these directions, you can efficiently complete the process of requesting a replacement check.

Follow the steps to accurately complete your request

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your employee name in the designated field. This should be your full legal name as it appears in your employment records.
3. Provide your employee Social Security Number (SSN) or member ID in the corresponding field. Ensure that the number entered is accurate to avoid any delays.
4. In the next field, fill in your employer’s name: Research Foundation for Mental Hygiene, Inc. Make sure it is spelled correctly.
5. State the name of the person or entity to whom the replacement check should be issued. Write it clearly in the specified line.
6. Indicate the amount for the check in the designated section. It is important to enter the correct figure to match your replacement request.
7. Provide the check number that needs to be voided or placed on stop-payment. This is typically found on the original check.
8. Fill in the date of the check that you are requesting a replacement for, ensuring the date reflects when the original check was issued.
9. Select the reason for the replacement check by checking the appropriate box. Choose from options like 'The original check was lost or stolen,' 'The original check was destroyed,' or 'I never received the original check.'
10. Acknowledge the terms regarding the eventual clearing of the original check by reading the statement below the reasons. If the original check clears and you have been reimbursed twice, you agree to repay the employer.
11. Sign the document in the field designated for employee signatures. You may need to use a digital signature tool if filling out the form online.
12. Finally, enter the date of your signature, confirming when you completed the request.
13. Once you have filled out all sections accurately, save your changes. You can also download, print, or share the form as needed.

Complete your Request For Replacement Check online today to ensure a smooth replacement process.