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

NOTICE OF DISHONOR OF CHECK Date: ___________________________ To: [fill in name and last known address of offender]                               A check, numbered ___________ , and dated ________________ , 20 ___ , drawn by you and made payable by you to [name of business or individual] ___________________________ in the amount of $ ___________ has not been accepted for payment by _________________________ , (which is the drawee bank designated on your check), due to insufficient funds. 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's fee which will be set by the court; (2) Interest on the amount of the check which shall accrue at the rate of twelve percent per annum from the date of dishonor; and (3) Three hundred dollars or three times the face amount of the check, whichever is less, by award of the court. You are also CAUTIONED that law enforcement agencies may be provided with a copy of this notice of dishonor and the check drawn by you for the possibility of proceeding with criminal charges if you do not pay the amount of this check within fifteen days after the date this letter is postmarked. Make your payment to _________________________ at the following address: Mail or deliver the total amount to the following:                               Notice Issued by: Signature: ________________________________ Print Name: _______________________ Title: _______________________