Worthless Check Information Sheet

The Worthless Check Information Sheet must be filled out and accompanied with a copy of each check that is sent to our office.  Please make additional copies of this form to accommodate your needs. 

Please note that along with this information, you must also provide proof that your business attempted to collect the money on your own- for example, a copy of the letter or email you sent to the individual in an attempt to collect.  Worthless Check Information Sheet