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Returned Check Notice

Document Overview

This is a fillable returned check notice. Click any blank field in the document below, type your information, and your entries will autosave in your browser. Use the toolbar at the top to print, save as PDF, or download a completed copy. Below the form, you'll find a guide to using this document, common mistakes to avoid, and answers to the questions we hear most often about returned check notice.

Date
Dr. / Mr. / Mrs. First name  Last name
Street address
City , State ZIP Code

Dear Honorific Last Name :

We appreciate your business. Unfortunately, your check made payable to Name , (Number Number , dated Date ) in the amount of $$ Amount has been returned to us due to insufficient funds. We have verified with your bank that your account's current balance is not enough to fund the check. Accordingly, we ask that you mail (or hand deliver) the amount of this checkYes / No   plus an additional service charge of $$ Amount to the following address: 

Street address

City , State  ZIP Code

Please provide this amount in cash, certified check, or money order only.

We recognize that mistakes happen and we look forward to an amicable resolution of this matter. However, we must insist that replacement funds be received at the above address no later than Date . If you have any questions, please call or email me at Contact Phone or Contact Email . If you have already sent in a substitute payment, please disregard this notice.

Sincerely,

_______________________________
Your Name
Your Title

PAGE BREAK HERE

DEMAND FOR FINAL NOTICE

Date
Honorific First Name  Last Name
Street Address
City , State Zip

RE:  Final Notice

Dear Honorific Last Name :

We have attempted several times to resolve the matter of your past due account. Unfortunately, we still have not received payment of the outstanding amount, which is now significantly in arrears. Your account is overdue in the amount of $Check Amount   plus an additional $Service Fee Amount  service charge .

This is your final notice. Unless we receive your payment for $$ Amount by Date , we will turn your account over for collection immediately. Please provide this amount by certified check or money order only.

We strongly urge you to take this opportunity to avoid expensive and time-consuming collection efforts and litigation. If you have any questions about your account, please call or email me at Phone or Email .

Sincerely,

_______________________________
Name
Title