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CHE CK N U MB E R C HEC K DATE ORIG I N AT I N G D EPART M EN T PAYE E C O NTAC T P H O NE NU M B E R AMO UNT $ Void Check P LEAS E EX P LAI N q Advance Not Used P LEAS E EX P LAI N q Issued in Error C HEC K N UM B ER q Invoice Paid on Another Check C HEC K DAT E P LEAS E EX P LAI N q Other: q Unclaimed Property (check still owed, cannot locate payee) q Issued to Wrong Payee q Issued in the Wrong Amount Void and Reissue Check q Check Damaged q Check Stale Dated SE N D CHE CK TO.

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