REGISTERED MAIL # 123 456 789 US

FROM: JOHN LEE DOE

C/O ANYWHERE
ADDRESS CITY, STATE AND [ZIP CODE]

TO: U.S. DEPARTMENT OF THE TREASURY

C/O STEVE MNUCHIN- SECRETARY OF THE
TREASURY
1500 PENNSYLVANIA AVENUE
NW WASHINGTON. D.C. 20220
RE: NOTICE OF PRIVATE STATUS
DATE: APRIL 14.2018

THE FOLLOWING ITEMS WERE SENT VIA USPS REGISTERED MAIL NUMBER: RM sticker 123 456 789 US
ACCEPTED FOR VALUE AND EXEMPT FROM LEVY. FOR CREDIT
AND DEPOSIT TO POST REGISTERED ACCOUNT NUMBER: ORIGINAL POST
REGISTERED MAIL NUMBER AND PASS THROUGH ACCOUNT NUMBERS:
SSN no - / cusip on back of SSC (red numbers)

1. Affidavit of Tax-exempt Foreign Status

2. Revocation and Termination of Franchise doc
3. Hold Harmless Agreement.
4. Certified Copy of UCC-1 and UCC-1 Addendum
5. Form W-8

TO: U.S. DEPARTMENT OF THE TREASURY 1500 PENNSYLVANIA AVENUE, NW

WASHINGTON, D.C. 20220

ATTENTION: STEVE MNUCHIN, SECRETARY OF THE TREASURY

NOTICE: PLEASE STAMP FILED/RECEIVED ON ALL DOCUMENTS AND RETURN

ALL DOCUMENTS AND RECORDS WITH IRS BATCHING NUMBERS TO THE C/O
MAILING ADDRESS ABOVE. ALL DOCUMENTS WERE CC'D TO: DEPARTAMENTO
DE HACIENDA P.O. BOX 9024140 SAN JUAN. PUERTO RICO 009024140

NOTICE TO AGENT IS NOTICE TO PRINCIPAL

NOTICE TO PRINCIPAL IS NOTICE TO AGENT