The notice of a photocopied check required by section 28-4-404A, Idaho Code, shall be imprinted on the jacket containing the photocopied check or the facsimile itself and the notice shall be substantially in the following form:
NOTICE OF PROCESSING OF PHOTOCOPIED CHECK.

A check drawn by you has been photocopied and the photocopy has been honored. The original of the check has been lost or mutilated, and the photocopy has been used for your convenience. We have attempted to insure that payment has been made only one time. This is your notice of this process so that you may check your statement of account to determine that payment has not been duplicated.