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Dishonored Check Form

Wholesalers and distributors are required to report any licensee purchasing alcoholic beverages with a bad check.

The first time this happens, the wholesaler or distributor is not required to report it, as long as the retailer makes the check good within seven days of being notified. Upon receiving the second bad check, within a period of 180 days, or if the first check is not paid in seven days after notification, both the first and any other bad checks must be reported to the ABC.

Any other checks after these are to be reported if they are returned from the bank. If you receive any documentation from the licensee's bank saying the check was returned due to a bank error, forward the documentation to us, and we will excuse that check.

Licensee Information

Licensee Number Trade Name Mailing Address City State Zip Code

Wholesaler Information

Name Street Address City State Zip Code License Number Representative Rep. Phone Number Rep. County/City Rep. Email

Check 1

Check Number Date Written Date Dishonored Date Retailer Notified Date Paid Reason Dishonored Amount

Check 2

Check Number Date Written Date Dishonored Date Retailer Notified Date Paid Reason Dishonored Amount

Check 3

Check Number Date Written Date Dishonored Date Retailer Notified Date Paid Reason Dishonored Amount

Check 4

Check Number Date Written Date Dishonored Date Retailer Notified Date Paid Reason Dishonored Amount

Check 5

Check Number Date Written Date Dishonored Date Retailer Notified Date Paid Reason Dishonored Amount

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Need Help?

Special agents in Virginia ABC's Compliance Unit offer leadership and guidance and serve as a reliable resource for the alcoholic beverage industry. Contact your compliance agent.

For dates, use the following format: MM-DD-YYYY.

For amounts, use U.S. dollars ($).

Wholesalers: The person listed as your “representative” will be subpoenaed to appear at administrative hearings of licensees cited for writing bad checks to your company.

Wholesalers: Please list the county or city in which your company resides (e.g., the mailing address may be Richmond, but the company resides in Henrico County). This information is needed in order for subpoenas to be sent to the proper agency for delivery.

Industry Resources: Distilled Spirits