Returned Check Policy. If a payment is made on an account by check, and the check is returned as Non-Sufficient Funds (NSF), Account Closed (AC), or Refer to Maker (RTM), the patient or the Patient’s Responsible Party will be responsible for the original check amount in addition to a $35.00 service charge. Once notice is received of the returned check, this office will contact the Responsible Party of the returned check. If a response is not made within 15 days from the date of contact by the Patient or the Responsible Party, the account may be turned over to our collection agency and a collection fee will be added to the outstanding balance – in addition to the $35.00 Check Service Charge.
Returned Check Policy. In the event any check is returned for non-payment, Guardian agrees to pay a returned check fee in the amount of $30.00 plus all costs of collection including, but not limited to, attorney’s fees and costs. I/We have read and understood this Agreement and agree to be bound by all terms and conditions of this Agreement and the documents incorporated into this Agreement. The terms of this Agreement will apply to all Services provided under this Agreement. Dated: (Guardian Signature) By: , Guardian (Guardian Print Name) Name: Address: City: Zip: Home Phone: Cell Phone: Employer: Work Phone: Email: Emergency person to contact in case we cannot reach you: Name: Phone: Name/Hospital: Address: Phone: Fax: Name: Breed: Birthday: Color: Weight: M / F (circle one) Spayed / Neutered (circle one) Name: Breed: Birthday: Color: Weight: M / F (circle one) Spayed / Neutered (circle one) Name: Breed: Birthday: Color: Weight: M / F (circle one) Spayed / Neutered (circle one) Pet’s Name: How long have you had your Pet? Where did you get your Pet? If adopted, do you have any information on your pet’s history? Circle all that describe your pet’s personality: Outgoing / verbally sensitive / timid / pushy / affectionate / submissive / insecure or clingy / excitable / playful / gentle / quiet or subdued / mouthy / other: Describe your pet’s activity level (circle one): Low / Medium / High How would you describe your Pet’s demeanor while riding in a car (circle one)? Enjoys / Dislikes / Neutral Is your pet crate trained? (circle one): Yes / No Circle all situations where your Pet may become unfriendly / react in a negative and/or aggressive manner: Grabbing collar / hugging / removing from furniture / touching while sleeping / touching ears, paws, mouth, tail Other: If you answered yes to any of the above questions, please circle the behavior/reaction that best describes your Pet in the aforementioned situation: Will bite / May bite / Growls / Shows teeth / Trembles / Moves away Does your Pet have any noise sensitivities? Does your Pet like children? Which flea preventative do you use? When was it last administered? Does your Pet have any health or physical issues that would cause restrictions on activities or movements? Does your Pet have any allergies? If yes, describe reaction: Does your Pet have any dietary restrictions? Does your Pet go to Pet Parks? If yes, has he or she ever exhibited aggressive behavior toward other Pets such as barking, baring teeth or raising hackles? Wh...
Returned Check Policy. I understand and agree to pay a $35.00 processing fee for any check that is returned from the bank. I agree to pay all future tuition in cash or money order, should two checks be returned from the bank.
Returned Check Policy. In the event that a check is returned to Don’t Stop Bouncing! LLC for insufficient funds customer agrees to pay the total rental price as well as an additional $20.00 fee to Don’t Stop Bouncing! LLC. In cash immediately upon notice.
Returned Check Policy. Licensee will be charged an additional $25.00 for returned checks in addition to any other monies owed such as the Rental Fee and/or deposit.
Returned Check Policy. A $75 fee will be assessed on all returned checks. This fee plus the amount of the original check is due promptly and must be paid via money order, certified funds, cash, or credit card.
Returned Check Policy. All returned checks will be charged $25.00 NSF check fee (fee subject to change without notification from owner/owner representative) plus late charges, and will be considered as additional rent.
Returned Check Policy. Any check that is accepted as payment by the Client to NVartistry and is subsequently returned by your bank will incur a $30 service charge. Future payments must be made in cash or money order, Venmo, or paypal only.
Returned Check Policy. For each check returned, the City of Moscow fee schedule permits the City to charge a $25 service charge to the rider. In addition, the rider must purchase a money order or pay in cash, credit card, or certified check to replace the returned check.
Returned Check Policy. I understand and agree to pay a $10.00 processing fee for each check returned from the bank. I agree to pay the full amount of the returned check including the return check fee within 5 days of notice.
