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

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

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NOTICE OF DISHONORED CHECK Date: ___________________________ To:                               You are hereby notified that Check No. ___________ , dated ___________ in the amount of $ ___________ , drawn upon ___________ and payable to ___________ has been dishonored for the reason of ________________ . Pursuant to South Dakota law (21-57-5), you have thirty (30) days from receipt of this notice to pay or tender to ____________________________________ (payee) the full amount of the check or instrument, plus additional charges, itemized as follows: Face amount of check: $ ___________ Returned check fee: $ 30.00 Incurred Court Costs: $ ___________ Filing Fees $ ___________ Accrued interest: $ ___________ TOTAL AMOUNT $ ___________ Unless this Total Amount is paid in full within the specified time above, you will be liable for damages including (but not limited to) the amount of the check, statutory damages of $100.00 or triple the amount of the check, whichever is greater (but not more than $200), plus costs of court. Mail or deliver the total amount to the following:                               Notice Issued by: Signature: ________________________________ Print Name: _______________________ Title: _______________________

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