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Notice of Dishonor of Draft
STATE OF ----------)
COUNTY OF ---------)
Please take notice that a draft for ---------- dollars
($----------), drawn by [name] on [institution], in favor of
[name], or order of [date], and payable on [date],
[acceptance or payment] of the draft was this day demanded, and
not having been [accepted or paid] was PROTESTED by the
undersigned Notary Public for [nonacceptance or nonpayment].
Holder looks to you for payment as [drawer or indorser].
*** If Required By State Law ***
This Section for Notary:
State of _________
County of ________ [COUNTY]
On [DATE] before me, [NAME OF NOTARY], notary, personally appeared [NAME OF PERSON(S) INVOLVED], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
My commission expires: _____