FORM III
FORM OF NOTING FOR DISHONOUR
[Section 8]

(To be made upon the instrument or upon a paper attached thereto, or partly upon each).
Reference to page in Notarial Register ________________________
Date of presentment and dishonour by non-acceptance/non-payment ________________
Reason, if any, assigned for dishonour (or, if the instrument has not been expressly dishonoured, reason why holder treats it as dishonoured).
Date of note ___________________
Signature of Notary
Notary’s charges.