Fill and Sign the Notice of Dishonored Check Civil Keywords Bad Check Bounced Check Michigan Form

NOTICE OF DISHONORED CHECK Date: ___________________________ To:                               A check, draft, or order, numbered ___________ , for payment of money drawn by you, dated ________________ , 20 ___ , in the amount of $ ___________ was returned to (name) _______________________________ , noted as dishonored for: Not sufficient funds; No account This notice is a formal demand for payment of the full amount of the dishonored check, draft, or order plus a processing fee of $25.00 for a total amount of $ ___________ . If you pay this total amount within 7 days, excluding weekends and holidays, after the date this notice was mailed, no further civil action will be taken against you. If you do not pay the $ ___________ within 7 days as requested above, but within 30 days after the date this notice was mailed you pay the amount of the dishonored check, draft, or order plus a $35.00 processing fee, for a total amount of $ ___________ , no further civil action will be taken against you. If you fail to pay either amount indicated above, I/we/our client will be authorized by state law to bring a civil action against you to determine your legal responsibility for payment of the check, draft, or order and civil damages and costs allowed by law. If you dispute the dishonoring of this check, draft, or order, you should also contact your bank or financial institution immediately. Make your payment payable to ___________________________ , at the following address: Mail or deliver the total amount to the following:                               Notice Issued by: Signature: ________________________________ Print Name: _______________________ Title: _______________________