WORTHLESS CHECK POLICY
Revised October 2014
The following are the general policies for prosecution of worthless/closed account checks by
the Montgomery County Attorney's office. These policies should be followed as closely as
possible. However, if you think that an exception should he made for your case, please contact
the County Attorney's office for approval.
Our office will not accept:
1. In State checks for $20.00 or less. These checks can be processed through Small Claims
Court. For information on how to file, contact the Clerk of the District Court’s offices in
Independence or Coffeyville.
2. Out of State checks under $1,000.00. Passing a worthless check under $1,000.00 is a
misdemeanor. It is almost impossible to extradite people charged with misdemeanors
from another state back to Kansas.
In a criminal case only $30 can be charged on each check to cover service charges. If the
receiver of the check files in Small Claims Court, an amount more than the face of the check
plus more in service charges can be requested.
Situations to avoid: Taking a check without obtaining the passer’s driver’s license information,
two-party checks, post-dated or pre-signed checks.
State law requires the passer to be notified by restricted, U.S. mail by the receiver.
The passer is to be given at least seven days to pay off the check. When a check is
submitted for collection or prosecution, include the green “Domestic Return Receipt” or the
unclaimed/undelivered letter with the original check. The receipt of the letter sent back by the
post office is proof the receiver notified or attempted to contact the passer as required. Do not
submit copies of the receipt.
Also, an “Affidavit or Prosecution” must be completed and signed in from of a Notary
Public. Staff members in our office can notarize the affidavit.
An offense report must be filled out by the person who actually took the check.
These forms, available in our office, are required for each check even if the passer wrote
more than one check to the same receiver.
Collection will be attempted before charges are filed. If a passer does not pay as requested, the
case will be turned over to a prosecutor for review. If the case is filed and it goes to trial, the
receiver will be required to testify. Once a check has been turned over to our office, do not
accept payment. If the passer offers to pay, tell the person to contact our office.
If you have any questions about worthless checks, please contact the County Attorney’s Office
at (620) 251-6022 or (620) 330-1020.
IN THE DISTRICT COURT OF MONTGOMERY COUNTY KANSAS
STATE OF KANSAS Plaintiff
vs CR
Defendant
AFFIDAVIT OF PROSECUTION
STATE OF KANSAS )
) ss
MONTGOMERY COUNTY )
COMES NOW, the undersigned and solemnly swears or affirms:
The return check # dated in the amount of $ was
given to on the day of
20 , by a person identified as
who was identified by means of
The check was personally received by from
the passer who can identify him/her.
1. That at the time the check was made, issued or passed, the maker or passer did not
indicate by words or action that he/she had no deposit in or credit with such bank or
that he/she did not have sufficient funds in or credit with such bank for the payment of
the check.
2. That we were not requested to hold the check.
3. That the maker or passer of said check did not borrow any money and give the checks as
security for the debt or loan.
4. That the check was submitted to the bank for payment during the usual course of
business and was not held.
5. That the check was not post-dated and was not presented for payment prior to the
postdated date.
6. That the check was returned and not paid.
7. That when the check was returned, we did on the day of
20 by restricted mail service, addressed to the address as it appears on the check,
advise of the failure of the check to clear the bank
and warned that if the check was not paid within seven (7) days, it would be submitted
for prosecution.
8. That we also notified by the following
means:
The returned check is submitted to the County Attorney’s Office for the purpose of prosecution
with the full understanding that the prosecution will not be dismissed because restitution has
been made.
I am aware that under the provisions of K.S.A. 21-3709, causing the unlawful prosecution for
worthless check is a Class A Misdemeanor.
Having read and sworn to the above and foregoing, I do hereby affix my signature this
day of , 20 .
AFFIANT
Subscribed and sworn to before me this day of , 20
NOTARY PUBLIC My commission expires
OFFENSE REPORT – WORTHLESS CHECK
To be completed and signed by the person who actually took the check.
Deliver this form, together with the check, registered letter receipt (green slip), the letter itself
if not delivered and/or a copy of the letter, and any regiscope pictures to the Investigating
Officer.
Name and address of the business and location where check was passed:
Full name of person who actually took the check:
Business Phone: Home Phone:
Home Address:
Date of Check: Amount of Check:
Date Check was cashed: Was this the full purchase price?
Can the person who accepted the check identify the passer?
Name of Passer:
Gender: Ethnicity: Age: Height:
Hair Color: Weight:
How dressed:
Any notable marks or traits:
Was regiscope picture taken:
By whom:
Did anyone else mark or approve check?
Unnown
White
Unknown
What identification was taken?
What knowledge do you have of the passer’s whereabouts?
Was check signed in your presence?
Any others present?
Was check made out before you saw it?
Have you done business with passer before?
Was the check post-dated?
Did passer actually say it was a good check?
Did the passer make any statement to the effect that he did not have enough money in the
bank at the time of the passing of the check to cover it?
Did you or your boss agree to hold the check for a period of time?
Has restitution been made, planned, or offered?
Purpose for which check was given:
If merchandise, what kind?
Has the merchandise been returned or complained about?
Has the check passer been notified in any other way?
If so, by whom, when, and how?
No
No
Unknown
Unknown
Unknown
Unknown
Both
Unknown
No
Did you accept the check in good faith believing that the money was on deposit at the time and
that the check would clear?
The undersigned states that he/she has actual knowledge of the facts set out above and will be
a witness in Court to the same.
Signature
VICTIM NAME
VICTIM ADDRESS
Date Sent
Restricted Mail Service
SUSPECT NAME
SUSPECT ADDRESS
RE: Return Check #
Written to:
Amount:
Dear SUSPECT
The above referenced check has been returned non-paid.
You have seven (7) days to pick up this check or prosecution may proceed, and a warrant may
be issued for your arrest.
I will accept !"#$%&'"$()&("$("*!+,-&(.+"*,&*/0
Make payable to: VICTIM’S NAME
In the amount of: $
This is the amount of the returned check; a State mandated service charge of $30.00 per
check and postage of $ .
Sincerely,
VICTIM NAME
