Parlier, CA · Fresno County
Request for Replacement of Lost/Stolen Check
This form lets a person request a replacement for a lost or stolen check from the City of Parlier Finance Department.
What this form is
Use this form to ask the City of Parlier Finance Department to replace a lost or stolen check. The form requests the payee’s contact details, check date and number if known, whether the check was endorsed, and how the replacement should be received. A police report must be attached for a stolen paycheck; the form warns that processing cannot be reversed if the original check is recovered.
Who needs it
A person whose City of Parlier check was lost or stolen can complete this request and submit it to the Finance Department.
How to submit it
Submit the completed form to the Finance Department at 1100 E. Parlier Ave., Parlier, CA 93648. Telephone requests will not be accepted.
About notarization
This document is signed and dated without a notary; attach a police report if the paycheck was stolen, and the signer just signs and dates the request.
How to submit this form
- 1
Download the Form
Download the Request for Replacement of Lost/Stolen Check.
- 2
Complete the Request
Provide your contact details, check information if known, and preferred method for receiving the replacement.
- 3
Gather Any Attachment
If the paycheck was stolen, attach a police report. Provide an updated mailing address if requesting delivery by mail.
- 4
Submit to the Finance Department
Submit the form to the Finance Department at 1100 E. Parlier Ave., Parlier, CA 93648. Telephone requests are not accepted.
Frequently asked questions
- Who can use the replacement check request?
- A person whose check was lost or stolen can complete the form and submit it to the Parlier Finance Department. It asks for contact and check details.
- Do I need a notary for the replacement check request?
- No. The request is signed and dated without a notary. If a paycheck was stolen, attach a police report.
- How do I submit the replacement check request?
- Submit the completed form to the Finance Department at 1100 E. Parlier Ave., Parlier, CA 93648. Telephone requests are not accepted.