Affidavit of Lost or Destroyed Check | Student Fiscal Services

Use this form to request a replacement for a Financial Aid/Refund check. This form must be completed by the person to whom the check was made payable to. Affidavits for Parent PLUS loans must be completed by the parent who borrowed the loan.

**Please note: An affidavit is a request to cancel and replace a check that is
lost, undelivered, or otherwise missing. Once submitted, the check will be
canceled and can no longer be deposited or cashed. If you receive or find the canceled check, do not attempt to deposit or cash it, as it may result in
fees from your bank.

If you have a balance due on your tuition account at the time you are
requesting a check affidavit, funds from the cancelled check may pay towards the balance due before a new check can be issued.

Payee's Full Name *

Student # *

Email *

Mailing Address *

Check # *

If you do not have the check number, enter N/A instead.

Amount *

Reason for request *

Send replacement check to *

*If selecting Direct Deposit, make sure that you have set it up on MyUW

Signature *

I am stating by submitting the information above that I am the payee for this check and that the check has been lost, destroyed, or not delivered to me. To the best of my knowledge, the check has not been cashed. I understand that if I request to cancel the check within 10 business days from the date it was first issued, it will result in a charge of $25 to the student account from which the check was issued. Furthermore, I affirm my understanding that this check will be canceled and I will not attempt to cash, deposit, or negotiate the check included in this affidavit. Should the check be found or delivered after I submit this affidavit form, I agree to void that check by writing "VOID" on it and either return the check to SFS, retain it for my records, or shred it.

For questions, call SFS Customer Service at 206-543-4694

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