Employee - Reissue Lost, Destroyed or Stale Dated Check

Employee - Reissue Lost, Destroyed or Stale-dated Check

To complete the Lost Check Replacement Form, you will need the paycheck date and check number for each paycheck you are requesting to replace. Please submit a separate form for each paycheck.

You can find the paycheck date and check number on your payslip in Workday. To access your payslips, navigate to:
Benefits & Pay > Pay > Payments > Payslips > View/Print

If you are unable to log in to Workday to view your payslips, please submit a PAYROLL TDX FORM for assistance. 
Please enter the name to whom the check is payable after the colon.
The employee ID number or NetID of the person for whom this request is being submitted.
This is important to ensure future mailings reach your destination.
Reason for Reissue Request:
Reason for Reissue Request:
Please describe any details that may aid in resolution.
Press Alt + 0 within the editor to access accessibility instructions, or press Alt + F10 to access the menu.

By checking Yes in the Reissue Attestation box, I agree to surrender immediately the original check to Cornell University should the original check come into my possession or control. I agree to not cash the original check as to do so will create an overpayment for which I will be responsible. I agree to repay the overpayment immediately if I do cash the original check.

Reissue Attestation
Reissue Attestation
Check pick up communication method
Check pick up communication method

Checks are available for pick up Monday - Friday, 8:30 - 11:30 am & 1pm - 4pm. If there are no arragements made ahead of time for check pickup, your check replacement will be placed in the mail to the address you provided above.

Other Fields

Your name
Verification Code