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DEMAND LETTER PURSUANT TO CIVIL STATUTE O.C.G.A. § 13-6-15 Date: TO: (Name) (Address) (City, State, Zip Code) FROM: (Name of Sender) (Address) (City, State, Zip Code) YOU ARE HEREBY NOTIFED that the following check(s) or instrument(s): Check Number Check Date Check Amount Name of Bank The above listed check(s) or instrument(s) were drawn upon: (HAS OR HAVE BEEN DISHONORED) Account Number Payable To Dear Sir/Madam: Pursuant to Georgia Law, you have ten (10) days from the receipt of this notice to tender payment of the full amount of the check(s) or instrument(s) plus a service charge of $20.00 or five percent of the face amount of the check(s) or instrument(s), whichever is greater. Total amount due Unless this amount is paid in full within the specified time above, the holder of the check(s) or instrument(s) may file a civil suit against you for two times the amount of each check or instrument, but in no case more than $500.00, in addition to the payment of the check(s) or instrument(s) plus any court costs incurred by the payee in this action. Sincerely, Name of Sender