SAO Vendor Stop Payment/Cancellation Request Form
200 Piedmont Avenue, Suite 1604 West Tower, Atlanta, GA 30334 Phone (404) 463-1993, Fax (404) 463-5089
Requesting Agency Name:
Agency PeopleSoft Business Unit:
Date Requested:
Requested by:
Requestor's Email Address:
Phone Number:
I. PLEASE COMPLETE THE FOLLOWING CHECK INFORMATION
Check Number:
Check Date:
Amount:
Payee:
Vendor Number:
Voucher Number:
II. Reason for Void/Stop AP Check:
Check Lost
Check Damaged
Check Not Needed
Paid Wrong Amount
Duplicate Payment
Incorrect Address
Incorrect Vendor
Stale Dated
Other
III. Choose one Payment Status for SAO to take:
Void
Stop
IV. Choose One Cancel Action for SAO take:
Re-Open Voucher(s)/Re-issue
Re-Open Voucher(s)/Put on Hold
Do Not Reissue/Close Liability
Note: If an agency has check in hand or if the original check is later found, please mail check to SAO Cash Management Group.
State Accounting Office Use Only
Date Check Voided:
Date Check Placed On Hold:
Date Stop Payment Placed:
Date Check Reissued:
New Check Number:
Processed by SAO:
SAO Form: 100-C
Indicates Response Required