Louisiana State University
Office of Accounting Services
Financial Accounting & Reporting
204 Thomas Boyd Hall
204 Thomas Boyd Hall • Baton Rouge, LA 70803 • P 225-578-3321 • F 225-578-7217
REQUEST FOR COPY OF AN LSU CHECK AS500
Request Date ______________________
Please obtain a copy of:
A copy of this check should be sent via:
___ E-mail to: _________________________________________
___ Fax to: ___________________________________________
___ Campus Mail to Department Above
___ Campus Mail to Other Department _____________________
___ US Mail to: ________________________________________
________________________________________
________________________________________
___ Other ____________________________________________
FOR ACCOUNTING SERVICES USE ONLY
_____ Check # _____________ has not cleared the LSU bank account as of ___________________.
A stop payment may need to be placed on the check and a replacement check requested.
Rev 08/13
Check #
Check Date
Check
Amount
Payee
LSU ID or Vendor #
Department
Contact
Email
Processed by
Date