NOTICE BY ADVERSE CLAIMANT -- STOP PAYMENT TO HOLDER
To:
_______________________ (maker or as the case may be)
_______________________ (address)
_______________________
__________ (Adverse claimant), of __________
(address), __________ (city), __________ (county), __________ (state), the
undersigned, objects to your making payment to __________ (present holder of
instrument), of __________ (address), __________ (city), __________ (county),
__________ (state), on an instrument dated __________, and by which you are to
pay __________ Dollars ($__________) to the holder of the instrument on
__________ (date). ______________
(Present holder of instrument) is not the rightful holder of the instrument
because __________ (designate reason, such as: __________ (he or she) acquired
the instrument by theft). The
undersigned is the rightful holder of the instrument and is entitled to receive
payment from you.
Pursuant to __________ (cite local enactment of UCC
§ 3-602), the undersigned demands that you make payment to __________ (him or
her). The undersigned has enclosed an
indemnity bond. This bond was issued by
__________ (surety company), of __________ (address), __________ (city),
__________ (county), __________ (state), for __________ Dollars
($__________). This bond is payable to
you on the condition that after you make payment to the undersigned on the
instrument described above, a court of competent jurisdiction may hold that
__________ (present holder of the instrument) was the rightful holder and force
you to make payment to __________ (present holder of instrument) on the same
instrument. The condition of this bond
also provides for payment to you of any costs that may be incurred by you in
any litigation that may arise from making payment to the undersigned.
Payment of the instrument may be made by mail to the
undersigned at __________ (address), __________ (city), __________ (county),
__________ (state).
Dated:
_____________________________
___________________________________
Signature
