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Get Payroll Payment Cancellation Request

Me Employee s UIN Paying Account ADLOC Employee s Department Pay Date Department Contact Department Contact s Telephone Number Department Contact s Email Address Explanation of Cancellation: Signature of Department (or designee ) Name (printed) Signature Title Date Submit Completed Form to: PVAMU Payroll Services Questions: Room 114 WR Banks Fax: 936-261-1955 payroll pvamu.edu 936-261-1904 Print Form.

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