Sample "Statutory Notice"

Date

Dear Check Writer:

You are hereby notified that a check numbered______ in the face amount of $________, issued by you on _________drawn upon __________ bank, and payable to ___________, has been dishonored. Pursuant to Indiana law you have 10 days from receipt of this notice to tender payment of the full amount of such check, plus a service charge which may not exceed the greater of $27.50 or 5% (not not more than $250) of the amount due.

Unless this amount is paid in full within the time specified above, we may turn over the dishonored check and all other available information relative to this incident to the Prosecuting Attorney’s Office for potential criminal prosecution.

Closing,
Your name/address