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Notice Of Renunciation--To Party Liable On Instrument
NOTICE OF RENUNCIATION-TO PARTY LIABLE ON INSTRUMENT
To: [name of party liable on instrument]
[address of party liable]
The undersigned, [Name of holder], of [address of holder], [city of holder], [state of holder], is the holder of a negotiable instrument executed on [date] by [Name of drawer] and drawn on [Name of drawee], of [address of drawee], [city of drawee], [state of drawee], for the payment of $[Amount of payment] Dollars on [date of payment] to the order of [Name of payee], of [address of payee], [city of payee], [state of payee]. The undersigned renounces all claim that [he or she] may have against you as [indorser or as the case may be] of the instrument described above.
Dated: [Date of notice]
signature