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Fill and Sign the Dishonored Checks it is the Goal of the Sherburne Form

Fill and Sign the Dishonored Checks it is the Goal of the Sherburne Form

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NOTICE OF DISHONOR OF CHECK Date: ___________________________To: A check drawn by you and made payable by you to ___________________________ in the amount of $_________ has not been accepted for payment by ___________________________, which is the drawee bank designated on your check. This check is dated ________________, 20___, and it is numbered, No. _________.You are CAUTIONED that unless you pay the amount of this check within fifteen (15) days after the date this letter is postmarked, you may very well have to pay the following additional amounts:(1)Costs of collecting the amount of the check, including an attorney fee which will be set by the court; and(2) Interest on the amount of the check which shall accrue at the rate of twelve percent (12%) per annum from the date of dishonor.Make your payment to ____________________________________ at the following address:_____________________________________________________________________________Notice Issued by:Signature: ________________________________Print Name: _______________________Title: _______________________

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