This form can be used for notifying a customer of a bounced check. Always keep a copy of this letter so that you can provide evidence that you attempted to collect the bounced check. You should also send this letter by registered mail/return receipt requested so that you have evidence of actual delivery.

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"Your Name"
"Your Title (if business)"
"Company Name (if business)"
"Address"
"City"

"Date"

"Their Name"
"Address"
"City"

Dear Customer:

We are holding your check payable to us, which has been returned by your bank. We certainly appreciate your business and request that you foward payment by__________ [insert date] for the amount shown below.

Check number
Amount of check
Service charge ______________
Total amount due

Thank you,

"Company Name "

"Your Name"
"Your Title "

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*Tennessee Law provides for a service charge of up to $20.00 for any returned check.