[Date, Month, Year]

To

[Cheque Issuer Name]

[Address line 1]

[City, State, Pin Code]

Sub: Request for payment

Dear Sir/Madam

I regret to inform you that your cheque no. __________________ in favor of _________________________ for the amount of Rs. ________________ was presented for payment this day through (name of the bank) and payment has been unfortunately refused by the Drawer Bank with the endorsement – “[Funds not sufficient]” vide [Returning Memo No. ] on [Cheque Return Date].

In these circumstances, I request you to pay me the above mentioned amount of Rs. [Cheque Amount] at the earliest.

Yours Truly,

For <NAME OF COMPANY>

[Cheque Payee Name & Address]