Overview

In the event that you receive a paper paycheck that is then lost, stolen, or damaged, University Payroll will issue a replacement check.

To initiate the replacement check process, you must complete the NC State University Payroll Office Affidavit and Indemnity Bond , have it notarized and submit it to University Payroll. Once the affidavit is received, the original check will be cancelled and a replacement check will be issued within three to four weeks.

Note: If the original check is found after this form has been submitted to University Payroll, it will be invalid and should be returned to University Payroll to be destroyed.

How to complete the NC State University Payroll Office Affidavit and Indemnity Bond (INV-19)

To complete the Affidavit and Indemnity Bond, you will need the original check number, the check issue date and the amount. The Payroll Coordinator for your department should have this information or you can contact the University Payroll office at hrpayroll@ncsu.edu.

This form must be notarized prior to submission. Notaries Public are available in the University’s Human Resource office.

Be sure to include your current mailing address. There is a place to enter you address below the line for your social security number.

As this is a legal document, this form must be completed in pen and no cross-outs or white out are allowed.

You can mail the notarized form to: NCSU Payroll Department, Campus Box 7233, Raleigh, NC 27695 or drop it off in the Payroll office located at 2711 Sullivan Drive. Faxed forms will not be accepted.