CERTIFICATE OF SERVICE

On Month_____, 2018, I mailed to:

STEVEN MNUCHIN – Secretary of the Treasury, or his Successor

Department of the Treasury
1500 PENNSYLVANIA AVENUE NW
WASHINGTON, DC 20220

The papers are identified as:

1. Power of Attorney in Fact

2. Cover letter (chargeback)
3. Bonded Bill of Exchange
4. Master Discharge and Indemnity Bond
5. Form 1040-ES
6. Copy of Accepted for Value Birth Certificate, other Documents
7. Copy of UCC-1 Filing

By mailing them in a pre-paid envelope and bearing Registered Mail # Certified Mail Num for Secured
Party Firstname Lastname.

My mailing location is:

c/o 1234 Your Address Lane, City, State Republic, near [12345]

Witness:

I am over the age of 18 and not a party to the transaction regarding the papers I mailed.

Dated

___(someone else signs as witness of service)___ ________________________________________

Printed Name Signature