The Bad Check Complaint Form is a crucial document designed to assist victims in reporting and seeking restitution for dishonored checks. By submitting this form to the Los Angeles County District Attorney’s Office, individuals can initiate the process of recovering funds lost due to bad checks. Understanding the eligibility criteria and the steps involved is essential for ensuring that the complaint is processed effectively.
The Bad Check Complaint form is an essential tool for individuals and businesses in Los Angeles County who have fallen victim to the issuance of a bad check. This form allows victims to report the incident to the Los Angeles County District Attorney’s Office, initiating a process aimed at recovering the funds lost due to the bad check. Before completing the form, it is crucial to confirm eligibility by answering a series of preliminary questions, such as whether the check was post-dated or involved a loan account. Each question must be carefully considered, as answering "yes" to any of them may render the check ineligible for the program. The form requires detailed information about both the victim and the check writer, including names, contact information, and specifics about the transaction. Victims must also provide documentation of any bank charges incurred due to the bounced check, as they may be eligible for reimbursement. Additionally, the form includes a verification section, where the individual filing the complaint affirms the accuracy of the information provided. Understanding the instructions and ensuring that all necessary details are included is vital, as incomplete submissions may delay or prevent prosecution. This comprehensive process not only facilitates restitution efforts but also helps deter future incidents of bad checks in the community.
When filling out the Bad Check Complaint form, there are important steps to follow to ensure your submission is complete and accurate. Here’s a list of things you should and shouldn’t do:
By following these guidelines, you can help ensure a smoother process when dealing with bad checks.
When dealing with the Bad Check Complaint form, there are several misconceptions that can lead to confusion. Understanding these can help ensure a smoother process for all involved.
By clearing up these misconceptions, you can better navigate the Bad Check Complaint process and enhance your chances of recovering your funds.
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BAD CHECK COMPLAINT FORM
12/03/2012
Step
1
Confirm Eligibility
LOS ANGELES COUNTY DISTRICT ATTORNEY
Bad Check Program Address:
Bad Check Program Contact:
P.O. Box 86407
(800) 842-0733
- Victim Hotline
Los Angeles, CA 90086-0407
(800) 269-0206
- Check Writer Hotline
For more information: da.lacounty.gov/badcheck.htm
1.
Was check post-dated at the time of acceptance?
Yes
No
Initial_________
2.
Does this matter involve a two-party check?
3.
Was check received as a payment on an loan account?
4.
Were you asked to hold or delay depositing the check(s)?
5.
Does the check involve an extension of credit?
* If any of the above are checked “Yes”, the check is ineligible for the program. See the back page for an ineligible list.
Victim/Merchant Name:__________________________________________________________________________________
2Contact Name: ____________________________________________ Title: ________________________________________
Victim
Victim Contact Information:
Email: ________________________________________________________
Information
(Required)
Phone:(______)___________________Fax:(______)__________________
• Email and/or fax are required for acknowledgement receipt of check and/or Program communication
Address:________________________________________City:______________________State:______Zip Code:____________
If assessed a bank charge(s) for the attached bad check(s) please state the amount of the bank charge per check
$_________________ (Per California Penal Code 1001.65 (c) you are eligible to be reimbursed up to $15 per check for assessed bank charges.)
Step Check Writer’s Name:_____________________________________________________
3Address:______________________________________________ Apt:______________
Check
City:__________________________________ State:________ Zip Code:___________
Writer
Home Phone:(_____)__________________Other Phone:(_____)__________________
Driver’s License # / Other ID #:
____________________________
State:
Date of Birth:
________
_____/______/_____
Other ID: (if applicable)
check here
“Courtesy Notice” must be sent to recover the bad check(s) in question. If no attempt has been made, the check may not eligible for prosecution. ( See courtesy notice on back.)
Ck. No.
Date Passed $ Amount Name of person accepting check
What was the
Can the check
(if no longer employed please list manager)
Check for?
writer be identified?
4
Address where check was accepted (if different than Step 2):______________________________________________________ (Required)
City:________________________________________ State:_______ Zip Code:____________________
•I will not accept direct payment from the check writer after filing this form with the Program. Please refer check writer to (800) 269-0206.
• I understand that the check writer has the option to dispute this claim in writing with the Bad Check Program.
5
• If this complaint form is not completely filled out it may prevent or delay this case from moving forward for prosecution review.
• I attest that I have sent courtesy notice to the check writer and after 10 days it remains unpaid.
• I have reviewed the filing instructions, I hereby affirm and attest under penalty of perjury, that all information provided on this complaint form is
Verification
true to the best of my knowledge.
Sign & date
X_________________________________________
________________________________________
_____________________
Signature of Person Filing (Required)
Print Name of Person Filing
Date Filed
Staple original or bank-generated substitute
Additional complaint forms are available at: da.lacounty.gov/badcheck.htm
For additional information and complaint forms: da.lacounty.gov/badcheck.htm
Sample “Courtesy Notice”
Date
Dear Check Writer:
You are hereby notified that a check numbered______ in the face amount of $________, issued by you on _________drawn upon
__________ bank, and payable to ___________, has been dishonored. You have 10 days from receipt of this notice to tender payment of the
full amount of such check plus a service charge of $_______, the total amount due being $_________.
Unless this amount is paid in full within the time specified above, we may turn over the dishonored check and all other available information relative to this incident to the District Attorney’s Office for potential criminal prosecution.
Closing,
Your name/address
Bad Check Program Information
As a victim of a bad check you may file this form with the Los Angeles County District Attorney, provided there is sufficient information, and that the check meets all eligibility guidelines. The Los Angeles County District Attorney’s Office will seek full restitution for victims whenever possible; however, please keep in mind that the Bad Check Restitution Program can make no recovery guarantees. By submitting the check to the program you surrender control of the check to criminal process and forego the opportunity to pursue civil debt collections.
Check writers are encouraged to make payments in full. Should a partial payment be received, the payment will be allocated between the victim and the Bad Check Program. “Restitution” refers to the face value of all checks listed on this report along with all “stated” bank charges assessed by your bank.
The following types of checks are ineligible for the program:
*Two-party checks
*Partially re-paid checks
*Fraudulent or stamped lost/stolen/forged
*Payroll, credit card or rent checks
*Post/pre dated or altered checks
*Checks you agreed to hold before depositing
*Checks passed outside of Los Angeles County
*Checks which are repayment of loan or civil contract agreement
What to do after my complaint form is filed with the Program
•Please do not accept direct payments from check writers. Should the check writer contact you to make payment, refer them to the Check Writer Hotline at (800) 269-0206
•You may contact Victim Services for case updates at (800) 842-0733 anytime.
•Please allow a minimum of 90 days to pursue restitution.
•If the check writer does not comply with the Program, the case may be reviewed for possible criminal prosecution.
•If we are unable to recover restitution and/or the check is not “eligible” for prosecution, you may request the check(s) be returned to pursue a civil remedy.
Filing Instructions
1.Fill out Complaint Form completely.
2.Attach checks or legal copies of all checks (front and back side of checks) and all supporting documents such as CERTIFIED MAIL RETURN RECEIPT OR UNDELIVERED LETTER, COPY OF “COURTESY NOTICE,” “RETURN ITEM” NOTICE FROM THE BANK (WITH FEES).
3.Mail Bad Check Complaint Form and all other correspondence to:
Los Angeles County Bad Check Restitution Program
P.O. Box 86407, Los Angeles, CA 90086-0407
4.Once a report has been filed: ALL restitution payments must be coordinated by the District Attorney’s Office. Should the check writer contact you to make payment, direct them to the Bad Check Restitution Program at (800) 269-0206.
DO NOT ACCEPT PAYMENT DIRECTLY FROM CHECK WRITER.
Small Claims Complaint Form: Like the Bad Check Complaint form, the Small Claims Complaint form is used to initiate legal action for unpaid debts. Both forms require detailed information about the parties involved, the amount owed, and the nature of the transaction. They serve as a starting point for seeking restitution through the legal system.
Demand Letter: A Demand Letter is similar in purpose to the Bad Check Complaint form, as both aim to resolve financial disputes. While the Bad Check Complaint is a formal submission to a legal authority, a Demand Letter is a direct request from the creditor to the debtor, outlining the amount owed and the consequences of non-payment.
Living Will: To ensure your healthcare preferences are respected, consider the comprehensive Living Will form guidelines that allow you to outline your medical treatment wishes in advance.
Notice of Dishonor: This document notifies the check writer that their check has been rejected by the bank, similar to the initial steps in the Bad Check Complaint process. Both documents serve to inform the check writer of their obligation to pay and the potential legal consequences if they do not.
Affidavit of Service: An Affidavit of Service is used to confirm that legal documents have been delivered to the appropriate party, much like the requirements outlined in the Bad Check Complaint form. Both documents emphasize the importance of proper notification to ensure that all parties are aware of the ongoing legal proceedings.
Creditors' Rights Complaint: This form is utilized when creditors seek to enforce their rights against debtors. Similar to the Bad Check Complaint form, it outlines the creditor's claims and the basis for seeking recovery. Both forms aim to facilitate the collection of debts through legal means.