Check Intermediary Form

This form is required when the check custodian releases a check to an intermediary custodian who will present a payee with a check (i.e. paying an entertainer at the time of a performance).

Download Check Intermediary Form (pdf)


The check custodian will complete the Payee Name and Check Number, sign,and date the form, then releasethe check to the intermediary custodian, who will immediately sign the form. The intermediary custodian will have the payee sign and date the form upon receipt of the check. The intermediary custodian will return the completed Check Intermediary Form to the check custodian, who will then return a copy of the form to Accounting Services when providing the completed Check Distribution Log.