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Here's the info you'll need to have handy to complete your doc:
Who the customer is
Have the name and contact info of whoever wrote the returned check ready.
How much they owe you
Know how much the check was for and whether there are any additional fees.
What's a Notice of Returned Check?
Someone gave you a bad check, and now you're out what they owe you. Although some believe aggressive correspondence is the best way to collect, if you're not ready to go that route, a notice of returned check and demand for repayment is a gentler way to approach the issue.