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

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 TC 47-29-101: If you pay the face amount of the check within ten (10) days of the postmark on the envelope containing this notice, you will satisfy your liability and owe nothing more. If, between eleven (11) and thirty (30) days (inclusive) of the postmark on the envelope containing this notice, you pay the face amount of the dishonored check ( $ ___________ ) , plus interest on that amount at the rate of 10% per year ($ ___________ ), plus returned check service charges ( $ ___________ ), plus court costs incurred ( $ ___________ ), plus reasonable attorney fees ( $ ___________ ), for a total sum of $ ___________ . If you do not pay within thirty (30) days, then upon the court’s finding of your fraudulent intent, you will owe the above charges, plus any increases therein due to court proceedings, plus triple the face amount of the dishonored check. Please pay the amount indicated (either the face amount of the check within 10 days, or the face amount plus the additional amount within 11-30 days) in order to avoid court proceedings. Mail or deliver the total amount to the following:                               Notice Issued by: Signature: ________________________________ Print Name: _______________________ Title: _______________________