"Date: ____
To: _____
You are hereby notified that the check(s) described below issued by you has (have) been returned to us unpaid:
Check date: ____
Check number: ____
Originating institution: ____
Amount: ____
Reason for dishonor (marked on check): ____
In accordance with Section 7-15-1, Utah Code Annotated, you are liable for this check together with a service charge of $20, which must be paid to the undersigned.
If you do not pay the check amount and the $20 service charge within 15 calendar days from the day on which this notice was mailed, you are required to pay within 30 calendar days from the day on which this notice is mailed:
If you do not pay the check amount, the $20 service charge, and the collection costs within 30 calendar days from the day on which this notice is mailed, in accordance with Section 7-15-1, Utah Code Annotated, an appropriate civil legal action may be commenced against you for:
In addition, the criminal code provides in Section 76-6-505, Utah Code Annotated, that any person who issues or passes a check for the payment of money, for the purpose of obtaining from any person, firm, partnership, or corporation, any money, property, or other thing of value or paying for any services, wages, salary, labor, or rent, knowing it will not be paid by the drawee and payment is refused by the drawee, is guilty of issuing a bad check.
The civil action referred to in this notice does not preclude the right to prosecute under the criminal code of the state.
(Signed) ____________________________________________________
Name of Holder: ____________________________________________________
Address of Holder: ____________________________________________________
Telephone Number: ___________________________________________________"
Utah Code § 7-15-2