CERTIFICATE OF SERVICE
On Month_____, 2019, I mailed a presentment 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 # Registered 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
_________________________________
Witness #2
_________________________________
Printed Name