Check Action Request Form - Fillable.docx 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Business Name or Payee Name in the designated field. This identifies who the check is for.
3. Optionally, provide your Email and Telephone Number for any follow-up communication regarding your request.
4. Fill in the Location/Site ID if applicable, followed by the Amount of Check you are requesting.
5. Select the type of request: either 'Void Request' or 'Re-issue Request'. Make sure to check the appropriate box.
6. Provide your Contact Name and Check Number for reference, along with the Money/Express Code if available.
7. In the Check details section, follow the instructions based on whether you have a physical check or not. If you do, mail both the form and check to EFS Check Clear at the specified address.
8. If you do not have a physical check or it is older than 30 days, email your completed form to efs.checks@wexinc.com.
9. Finally, sign and date the form to confirm your request before submitting it through your chosen method.

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