Pay Stub Copy Form
Request for Copy of Check Stub Cost
$1.00 per sheet
If you would like payroll to provide you with a copy of your check stub information, please do the following:
1) Go to the Disbursing Office (formerly Treasurer’s Office) on the 4th floor and pay $1.00 per each sheet that you are requesting.
2) Complete the following information.
Name:__________________________ Social Security #:__________________
School/Dept:_____________________ Job/Position:_____________________
3) List the specific pay dates that you are requesting a copy of
________________________________ ________________________________
4) Attach copy of receipt from Disbursing. Place form in “Completed Forms” tray.
The requested copies will be mailed to you within 3 working days. Copies will be sent to your current address on file. Should you need a change of address, please go to our Human Resources Department.
