Stop Payment/Reissue Paycheck Form - Faculty/Staff

College faculty or staff members requesting a stop payment/resissue paycheck must complete this form. Please be exact with dates and amounts. Email payroll@middlebury.edu if you have any questions. 

This form is to be completed by a Middlebury College faculty or staff member only. If you are a student, please submit the student's form here.

Please note: A minimum of 5 days is required for a check to be reissued. 

First/Last Name
$
I certify that the above paycheck is missing and that, if found, it will be returned to the Payroll Office immediately