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Bad Check 10 Day Letter

2. Date
   Date

4. From:

   Please state from whom this letter is from.

6. Address of Sender

8. City

9. State

10. Zip

12. You are hearby notified that your bank has dishonored a check issued by you and described below. Pursuant to Georgia law, you have ten (10) days from receipt of this notice to tender payment of the full amount of the check plus any and all service charges due per check. Unless the total amount due is not paid in full within the specified time above, the holder of the check or instrument may turn over the dishonored check or instrument and all other available information related to this incident to the Probate/Magistrate Court for the issuance of a criminal warrant or citation or to the district attorney or solicitor for criminal prosecution.

14. Name

    Prosecutor

16. First Name

17. Last Name

19. Address1

21. City

22. State

23. Zip

25. Bank Name:

26. Check # :

27. Date of Check

28. Amount of Check:

30. Service Charge Due:

31. Total Amount Due:

Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

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35. Submit

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