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

NOTICE OF DISHONORED CHECK Date: ___________________________ To:                               You are hereby notified that a check or instrument numbered: ___________ , apparently issued by you on ___________________________ [date], in the amount of $ ___________ , drawn upon ___________________________ [name of bank], and payable to ___________________________ , has been dishonored. Pursuant to Montana Code §27-1-717, you have ten (10) days from receipt of this notice to tender payment of the total amount of the check or instrument, plus a service charge of $ ___________ (not to exceed $30.00 per check), the total amount due being $ ___________ . Failure to pay the above amount within the period specified may also result in damages assessed against you in the amount of one hundred dollars ($100) or triple the amount of the check, whichever is greater, not to exceed the amount of the check by more than five hundred dollars ($500). Unless this amount is paid in full within the time specified above, the dishonored check or instrument and all other available information relating to this incident may also be turned over to the authorities for criminal prosecution. Make your payment to ___________________________ at the following address: Mail or deliver the total amount to the following:                               Notice Issued by: Signature: ________________________________ Print Name: _______________________ Title: _______________________