AFFIDAVIT OF SERVICE

Cook County )
Illinois State ) affirmed and subscribed:
United States of America )

I, the undersigned, hereby certify:

1. I am over the age of 18 years and I am not a party to this action.

2. I served the following documents:
a. NOTICE OF SETTLEMENT OFFER (ten pages); and
b. DEBTOR AUTHORIZATION LETTER (one page); and
c. REQUEST REGARDING STATEMENT OF ACCOUNT (two pages); and
d. INTERNATIONAL POSTAL MONEY ORDER written to JP MORGAN CHASE BANK, N.A. for
$1000.00; and
e. AFFIDAVIT OF SPECIFIC NEGATIVE AVERMENT (two pages); and
f. UCC-1 (BAILOR/BAILEE) FILING (two pages); and
g. UCC-1 Acknowledgement Cover Page (one page); and
h. reference copy of AFFIDAVIT OF SERVICE (one page)
3. Service was made on ___________ _____, 20___ by USPS Registered Mail Article # RR 111 222 333 US at the
address(es) indicated as follows:

JP MORGAN CHASE BANK, N.A., c/o James L. Dimon, President and Chief Executive Officer, 38TH FL, 270
PARK AVE, NEW YORK, NY 10017

hereinafter, “Recipient(s),” the documents and sundry papers regarding JOHN DOE ACCOUNT NO. 38234823423 by
placing same in a postpaid envelope properly addressed to Recipient(s) at the said addresses and depositing same at an
official depository under the exclusive face and custody of the United States Post Office.

I certify under penalty of perjury under the laws of the United States of America that the foregoing is true and
correct.

Executed on _____ / _____ / 20_____

By: ____________________________________ (seal)

AFFIANT

JURAT

State of Illinois )
) affirmed and subscribed
County of Cook )

Subscribed and sworn to (or affirmed) before me on this _____ day of ___________________, 20_____, by John Doe,
proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me.

_______________________________
(Signature of notarial officer)

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