CERTIFICATE OF NON-PERFORMANCE

STATE OF CALIFORNIA
COUNTY OF ORANGE
PRESENTMENT

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Be it known, that, the person signing below, a duly empowered Notary Public, at the request

1234 Main Street, Huntington Beach, CA 92648

John Henry Doe
of_____________________________ In care of _______________________________________________________________________:
Claimant

Address

NOTICE OF TENDER FOR SETOFF; and

April 17, 2010
April 17, 2010
REGARDING A STATEMENT OF ACCOUNT
did duly present on ________________ the attachedREQUEST
________________________________________________
dated _______________
JONES, CFO, c/o ABC BANK, N.A., 555 BANKER STREET, PASADENA, CA 91101; and
toJACK
_____________________________________________________________________________________________________________
R.K. ARNOLD, C/O MORTGAGE ELECTRONIC REGISTRATION SYSTEMS, INC, 1818 LIBRARY STREET, SUITE 300, RESTON, VA 20190
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
Respondent(s)

John Henry Doe

signed by ___________________________ demanding performance of the following duties:
To give notice of and execute or cause to be executed a Notice of Rescission and Deed of Full Reconveyance
_______________________________________________________________________________________________________________,
the time limit having elapsed for timely performance thereto.
DEFAULT
Whereupon, the Notary Public signing below, for the reason dishonor by non-response/non-performance, does publicly and
solemnly certify the dishonor as against all parties it may concern by reason of non-response/non-performance thereof and stipulations
therein.
April 28, 2010
NOTICE
The undersigned Notary Public, certifies that on ___________________Notice(s) of Fault were sent to the parties noted below
by depositing in a depository of the United States Postal Service within the State indicated herein a sealed envelope containing said Notices(s)
directed to the respective person(s) or entity(ies) at the last known corresponding address noted below:
NAME
JACK
JONES
_________________________________
R.K. ARNOLD
_________________________________

c/o____________________________________________________________________________
ABC BANK, N.A., 555 BANKER STREET, PASADENA, CA 91101; and
c/o Mortgage Electronic Registration Systems, Inc, 1818 Library Street, Suite 300, Reston, VA 20190
____________________________________________________________________________

_________________________________

____________________________________________________________________________

_________________________________

____________________________________________________________________________

TESTIMONY

ADDRESS

In testimony of the above, I have signed my name and attached my official seal

___________________________________________
Notary Public
August 9, 2013
My commission expires: __________________
April 28, 2010
Date __________________

Cindy Smith
1234 Main Street
Huntington Beach, CA 92648