Sample Worthless Check Notice

“This statutory notice is provided pursuant to Section 13A-9-13.2 of the Alabama Code.  You are hereby notified that a check or instrument numbered _____________________, apparently issued by you on _____________________________.(date), drawn upon ____________________________(name of bank), and payable to ______________________, has been dishonored.  Pursuant to the Alabama law, you have 10 days from receipt of this notice to tender payment of the full amount of such check or instrument plus a service charge of not more than $30.00, the total amount due being $_______.  Unless this amount is paid in full within the specified time above, the holder of such check or instrument may assume that you delivered the instrument with intent to defraud and may turn over the dishonored instrument and all other available information relating to this incident to the proper authorities for criminal prosecution.”
NOTE:  This notice must be sent via certified or registered mail, return receipt requested, to the check-writer’s address.