Stop Payment/Reissue Paycheck Form - Student

Students requesting a stop payment/resissue paycheck must complete this form. Please be exact with dates and amounts. Email if you have any questions. 

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

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

First/Last Name
MC Box Number or MIIS Address
I certify that the above paycheck is missing and that, if found, it will be returned to the Student Employment Office immediately.