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Notice by:John Henry Doe, Principalc/o P.O. Box 81188
Bayside, California [95524] Non-DomesticDate of Notice: 30 October 2008
Notice for:Henry M. Paulson, Jr., Secretary of the TreasuryDepartment of the Treasury c/o 1500 Pennsylvania Ave NW Washington, D.C. 20220
Service by:U.S.P.S. Registered Mail Article No. RR111222333US, with return receiptIn the matter of: Certificate of Live Birth No. 999999999, Accepted for Value and Exempt from Levy
I, John Henry Doe, hereby duly notice Henry M. Paulson, Jr., Secretary of the Treasury, Department of the Treasury, with (1) my acceptance for value of "Certificate of Live Birth: numbered: 999999999, and (2) the issuance of the Private, Non-Negotiable Bond for Set-off, numbered: RRxxxxxxxxxUS. Notice to the Agent is notice to the Principal. Notice to the Principal is notice to the Agent. All Rights Reserved.
Enclosed are the following instruments:
1. original Private, Non-Negotiable Bond for Set-off, numbered: RR111222333US, in the amount of: ^'Unlimited'^; and,cerMfied copy of ''Certificate of Live Birth", numbered: 9999999, duly endorsed as follows: "ACCEPTED FOR VALUE" "EXEMPT FROM LEVY" H(autograph) (seal)"
"Exemption ID# 123456789”'(DEPOSIT TO THE U.S. TREASURY AND CHARGE”
“THE SAME TO JOHN H DOE 123-45-6789,J.
Please deposit said Bond, numbered: RR111222333US, to the credit of the Department of the Treasury, further credit to the account of JOHN H DOE 123-45-6789, as mandated by the Bond Order.
You have been duly noticed.
By:
John Henry Doe, Principal
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