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Notice and Direction

TO: [Name of Person who Owes the Debt (Debtor)]

TAKE NOTICE that the undersigned, [Name of Assignor] (the "Assignor") has assigned to
[Name of Assignee] (the "Assignee") all of its right, title and interest in and to the debt owing by
you to the Assignor in the amount of [Amount of Debt (ie. $25,000)] (the "Debt").

You are hereby irrevocably authorized and directed to make all future payments under the Debt
directly to the Assignee as follows:

[Name of Assignee]
[Address of Assignee]

[Telephone No. of Assignee]

Let this be your good and sufficient authority for so doing.

Dated this _____ day of ____________________, 20_____.

Witness [Name of Assignor]

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