SECTION

FIVE
 TABLE OF CONTENTS

SECTION 5: FORMS & INFORMATION

1. PRESIDENTIAL EXECUTIVE ORDERS

2. STRAWMAN/REAL MAN TERMINOLOGY

3. AFFIDAVIT OF RECORDING - Witnesses (for online COUNTY

RECORDING with only one Property List in Section 1)

4. AFFIDAVIT OF RECORDING - Notary version for above

recording

5. STAMP EXAMPLES (2 pages)

6. AGENCY MAILING LIST

A. Instruction Sheet
B. Large Labels -- FOR AGENCY MAILINGS (2 PAGES)
C. Small Labels -- ADDRESS LABELS FOR GREEN RETURN RECEIPT CARDS (2)
PRESIDENTIAL EXECUTIVE ORDERS AND LAWS
JOHN WARNER NATIONAL DEFENSE AUTHORIZATION ACT
1. PASSED OCTOBER 17, 2006
2. VOIDED THE POSSE COMITATUS ACT
3. ALLOWS FOR MILITARIZED POLICE ROUNDUPS
4. ALLOWS FOR THE DETENTION OF PROTESTORS, ILLEGAL ALIENS AND
UNDESIRABLES IN FEMA PRISONS

MILITARY COMMISSIONS ACT OF 2006

1. REMOVES THE RIGHT OF HABEOUS CORPUS
2. GIVES DICTATOR POWERS TO THE PRESIDENT
3. ENEMY COMBATANT STATUS CAN BE DECLARED BY AN UNFOUNDED
ACCUSATION
4. REDEFINES TORTURE AND ALLOWS TORTURE UPON AMERICAN CITIZENS WHEN
ACCUSED OF BEING AN ENEMY COMBATANT
5. TORTURE MAY BE USED TO THE POINT OF MAJOR ORGAN FAILURE OR DEATH
WITH COMPLETE IMMUNITY FROM PROSECUTION

VIOLENT RADICALIZATION AND HOMEGROWN TERRORISM ACT OF 2007 - HR1955

1. INTRODUCED BY REPRESENTATIVE JANE HARMON DEMOCRAT FROM
CALIFORNIA
2. AMENDS PATRIOT ACT TO INCLUDE CIVILIAN POPULATION OF U.S.
3. MAKES THOUGHTS AGAINST THE POLITICALLY CORRECT IDEAS OF THE DAY A
CRIME
4. MAKES THOUGHT CRIMES A TERRORIST ACT

REAL ID ACT
1. U.S. CITIZENS WILL BE REQUIRED TO HAVE A NATIONAL ID CARD TO:
a. TRAVEL
b. ENTER A FEDERAL BUILDING
c. APPLY FOR ANY PUBLIC BENEFIT OR PROGRAM

FOREIGN INTELLIGENCE SURVEILLANCE ACT

1. ALLOWS SECRET WARRANTS FROM A SECRET COURT TO INVADE YOUR PRIVACY
2. FISA TEAMED UP WITH AT&T AND VERIZON COMMUNICATIONS COMPANIES TO
SPY ON U.S. CITIZENS
3. PHONE CALLS AND EMAILS OF AMERICANS ARE BEING TRACKED ACCORDING TO
DOCUMENTS BROUGHT FORWARD BY MARK KLIEN OF AT&T
4. PRIVACY WAS REDEFINED BY BUSH ADMINISTRATION. DEFINITION NO LONGER
MEANS ANONIMITY
5. BUSH ADMINISTRATION WAS SPYING ON U.S. CITIZENS 7 MONTHS BEFORE
SEPTEMBER 11, 2001
NATIONAL SECURITY ADMINISTRATION
1. WAS CREATED BY PRESIDENT TRUMAN IN 1952
2. ANALYZES MILLIONS OF PHONE CONVERSATIONS EACH DAY
3. COMPILES DATA BASES OF MILLIONS OF U.S. CITIZENS PHONE CONVERSATIONS
4. ESTIMATED 38,000 EMPLOYEES AND 43.5 BILLION DOLLARS PER YEAR BUDGET
5. WORKS WITH CENTRAL INTELLIGENCE AGENCY, NATIONAL RECONAISSANCE
OFFICE, FEDERAL BUREAU OF INVESTIGATION AND FISA TO INVADE THE
PRIVACY OF U.S. CITIZENS
PRESIDENTIAL EXECUTIVE ORDERS

 10990 - POWER TO CONTROL HIGHWAYS, MODES OF TRANSPORTATION AND

SEAPORTS
 10995 - POWER TO SEIZE CONTROL OF COMMUNICATIONS, MEDIA INTERNET,
RADIO AND TELEVISION
 10997 - POWER TO CONTROL ELECTRICITY, FUEL AND MINERALS
 10998 - POWER TO SEIZE ALL MEANS OF TRANSPORTATION, INCLUDING
PERSONAL, CARS, TRUCKS, BOATS AND PLANES, ETC.
 10999 - POWER TO SEIZE ALL FOOD SUPPLIES AND FARMS
 11000 - ALLOWS GOVERNMENT TO MOBILIZE CIVILIANS INTO WORK BRIGADES
UNDER GOVERNMENT SUPERVISION
 11001 - POWER OVER ALL HEALTH, EDUCATION AND WELFARE FUNCTIONS
 11002 - GIVES POSTMASTER POWER TO REGISTER ALL CITIZENS
 11003 - POWER TO CONTROL OF ALL PRIVATE AND COMMERCIAL AIRPORTS AND
AIRCRAFT
 11004 - ALLOWS THE HOUSING AND FINANCE AUTHORITY TO RELOCATE
COMMUNITIES, BUILD NEW HOUSING AND DESIGNATE AREAS TO BE ABANDONED
 11005 - POWER OVER RAILROADS, INLAND WATERWAYS AND STORAGE
FACILITIES
 11921 - GIVES FEMA CONTROL OF BANKS
REFERENCES:

1. INDYMEDIA.ORG
2. COMMONDREAMS.ORG
3. NEWSWITHVIEWS.COM
4. TRUTHOUT.ORG
5. TAKEBACKWASHINGTON.COM
6. OUTTHERETV.COM
7. MERIA.NET - STREAMING RADIO
8. 1100KNFX.COM
9. 911.ORG

“The time is near at hand which must determine whether Americans are to be free men or
slaves.” - George Washington
 STRAWMAN/REALMAN TERMINOLOGY

STRAWMAN Real Man

ALL CAP NAME Upper Lower Name
SSN With Dashes SSN No Dashes

ORGANIZATION Individual

DEBTOR Secured Party Creditor

BAILEE Bailor

TRUST Trustee

GRANTOR Grantee

CONDUIT

TRANSMITTING UTILITY

JOHN LEE DOE John Lee Doe

STRAWMANADDRESS c/o RealManAddress
CITY, STATE ZIP CODE City, State; near[RMZipCode]
Non-Domestic without the US
 Section 5 – WITNESS VERSION – If you do your county recording of the SECTION 1 Freedom Docs
online with nationalrepublicregistry.com (NRR), or in a county other than your residence
county, you’ll then need to record this Affidavit document in your residence County. (If you move,
record one in your new county.) Call and ask which county office has the Miscellaneous File for
Public Record, the cost to record, & the margin size & how many inches of blank space you need at
the top in order to record a one-page Affidavit. You may need to adjust margins or retype to
reformat & pull line-spacing together in the list so this is all on 1 page. NOTE: You will get a Liber
Number when you record this Affidavit and you will use THIS Liber # for your documents. If your
county refuses to record this (some do & then someday you’ll do the Neg. Aver. Process to re-
establish a Public Record in that county), try a neighboring county, or as last resort use the Liber #
from your non-resident county filing, in your docs. Do not use the NRR address as a Liber #. Delete
this blue note.

AFFIDAVIT OF RECORDING
On this _________day of ____________, 20______, for the purpose of notification, I, the undersigned
Secured Party Creditor and three witnesses located in the County of County and State of
State, do solemnly swear or affirm that Name of Secured Party Creditor recorded this
Affidavit of Recording in the above named County. This Affidavit verifies that the following
documents listed below are recorded at the (Use this following info if you did an online
filing) following website URL for public viewing.
http://www.nationalrepublicregistry.com/public/state.dateNumber,pdf(File Number
from NRR Docs) (Or use this following info if you recorded in a non-resident county)
CountyRecordingOffice, RecordingCounty County, RecordingState, Liber Number.

Number of Pages
1. CERTIFICATION OF ELECTRONIC RECORDING (Enter if you used this recording method; otherwise delete) 1
2. ACKNOWLEDGMENT OF FILING (Enter if you received this for your UCC recording – otherwise delete this line) 1
3. UCC1 and ADDENDUM 2
4. ATTACHMENT “A” - PROPERTY LIST 5
5. POWER OF ATTORNEY 2
6. COMMERCIAL SECURITY AGREEMENT 4
7. INDEMNITY BOND/ LIEN 1
8. HOLD HARMLESS AND INDEMNITY AGREEMENT 2
9. NON-NEGOTIABLE SECURITY AGREEMENT 1
10. LEGAL NOTICE AND DEMAND 8
11. LEGAL NOTICE & DEMAND DEFINITIONS 7
12. ACT OF STATE with APOSTILLE (Enter what you have . . . Apostille optional, but highly recommended) 2

Signature Signature
_____________________________________________________ __________________________________________________
Witness Name First Witness Witness Name Second Witness

_____________________________________________________ __________________________________________________
Printed Printed

Signature Signature
_____________________________________________________ __________________________________________________
Witness Name Third Witness Secured Party Name, Secured Party Creditor

_____________________________________________________ __________________________________________________
Printed Printed
 Section 5 – NOTARIZED VERSION – If you do your county recording of the SECTION 1 Freedom Docs
online with nationalrepublicregistry.com (NRR), or in a county other than your residence county, you’ll
then need to record this Affidavit document in your residence County. (If you move, record one in your new
county.) Call and ask which county office has the Miscellaneous File for Public Record, the cost to record, &
the margin size & how many inches of blank space you need at the top in order to record a one-page Affidavit.
You may need to adjust margins or retype to reformat & pull line-spacing together in the list so all is on 1
page. NOTE: You will get a Liber Number when you record this Affidavit and you will use THIS Liber # for
your documents. If your county refuses to record this (some do & then someday you’ll do the Neg. Aver.
Process to re-establish a Public Record in that county), try a neighboring county, or as last resort use the
Liber # from your non-resident county filing in your docs. Do not use the NRR address as a Liber #. Delete
this blue note.

AFFIDAVIT OF RECORDING
On this _________day of ____________, 20______, for the purpose of notification, I, the undersigned
Secured Party Creditor recorded this Affidavit of Recording in ____________________COUNTY in
the STATE of ________________________________________. This Affidavit verifies that the following
documents listed below are recorded at the (Choose this for online filing): following
website URL for public viewing.
http://www.nationalrepublicregistry.com/public/state.dateNumber,pdf(File Number
from NRR Docs) (Or choose this for recording in a non-resident county):
CountyRecordingOffice, RecordingCounty County, RecordingState, Liber Number.

Number of Pages
1. CERTIFICATION OF ELECTRONIC RECORDING (Enter if you used this recording method; otherwise delete) 1
2. ACKNOWLEDGMENT OF FILING (Enter if you received this for your UCC recording – otherwise delete this line) 1
3. UCC1 and ADDENDUM 2
4. ATTACHMENT “A” - PROPERTY LIST 5
5. POWER OF ATTORNEY 2
6. COMMERCIAL SECURITY AGREEMENT 4
7. INDEMNITY BOND/ LIEN 1
8. HOLD HARMLESS AND INDEMNITY AGREEMENT 2
9. NON-NEGOTIABLE SECURITY AGREEMENT 1
10. LEGAL NOTICE AND DEMAND 8
11. LEGAL NOTICE & DEMAND DEFINITIONS 7
12. ACT OF STATE with APOSTILLE (Enter what you have . . . Apostille optional, but highly recommended) 2

LS: ______________________________________________________________
Real Man Name, Secured Party Creditor Date

ACKNOWLEDGEMENT OF NOTARY
State of ________________________ )
) ss.
County of ______________________ )

On the______ day of_______________, two thousand-nine, before me, _____________________________, Notary,

personally appeared John Lee Doe, known to me (or proved to me on the basis of satisfactory evidence of
identification) to be the living man/woman whose name is subscribed upon this instrument and acknowledged to me
that he/she executed the same in his/her authorized capacity; and by his/her signature on this instrument, John Lee
Doe has acted on behalf of the person who executed this instrument.

Witnessed by my hand and official seal, _____________________________________________

My Commission Expires: _________________________ SEAL

________________STAMPS_________________
(COPY & DEFICIENT are TWO–two–2–different stamps.) COPY is black & used on the Actual and Constructive
Notice, Birth Certificate Bond, and the International Bill of Exchange in each of the 18-AGENCY packets, & when to
designate papers as a “COPY” - - could also be red. This COPY stamp is Arial Black in 48-point. DEFICIENT is
ONLY used for Civil cases when sued, NEVER with Criminal cases. Get instructions to use it for court papers.

COPY
On left is FranklinGothicMedium 48 pt. / right is Impact 48pt.
(Arial Black 48 pt. is thick, but more space between letters.)

DEFICIENT DEFICIENT
STAMP NAME: Envelope Stamp - - - Put on the front of the envelope every time you send a BPN to discharge
public debt.
FONT: Times New Roman 14-point

PRIORITY / CONFIDENTIAL

STAMP NAME: Envelope Stamp - - - Put on the back of the envelope every time you send a BPN to discharge
public debt.
FONT: Times New Roman 14-point

ATTENTION CFO

(Match the Alphabet Letter on the back of your SS card with the following list,
& the corresponding Bank’s number is your DTC Routing Number)
Federal Reserve Bank Routing Numbers
A - BOSTON - 0110-0001-5 G - CHICAGO - 0710-0030-1
B - NEW YORK - 0210-0120-8 H - ST. LOUIS 0810-0004-5
C - PHILADELPHIA - 0310-0004-0 I - MINNEAPOLIS - 0910-0008-0
D - CLEVELAND - 0410-0001-4 J - KANSAS CITY - 1010-0004-8
E - RICHMOND - 0510-0003-3 K - DALLAS - 1110-0003-8
F - ATLANTA - 0610-0014-6 L - SAN FRANCISCO - 1210-0037-4
STAMP NAME: 7-Line AFV Bill/Presentment/Statement Stamp - - - This closes the account. Discharge the total
amount of the bill. Hand print/write, use from computer, or stamp at a 45-degree angle. Goes on front & back of every
paper. Make no smaller than 10-point print. The following is FONT: Arial 10-point, centered.
ACCEPTED FOR VALUE AND RETURNED FOR VALUE
Stamp is in red.
Use BLUE to fill in. FOR SETTLEMENT AND CLOSURE

The “Fed. Res. Bank Routing #s” are SOCIAL SECURITY NUMBER __________________ (with dashes for STRAWMAN)
on the bottom of the last page & are in
the “Fed Res Bank Routing Numbers” DTC ROUTING NUMBER ______________________ (Fed. Res. Bank Routing #)
file in the EXTRAS folder. Find the bank
which corresponds with the alphabet DTC ACCOUNT NUMBER _____________________ (0+8 numbers on back of SS card)
letter on the back of your SS card. Use
that corresponding bank’s ID# as YOUR BY: _____________________________________ (Real Man Autograph)
“Fed. Res. Bank Routing #.”
DATE: _________________________________

STAMP NAME: 6-Line AFV Credit Card Stamp - - - Used to discharge most of the account. This doesn’t close the
account. Leave at least $50 in the account so that you don’t discharge it completely. Hand print/write, make in the
computer or use a stamp - - - a 45-degree angle, lower left to upper right. Make no smaller than 10-point print. The
following is FONT: Arial 10-point, centered.
Stamp is in red. ACCEPTED FOR VALUE AND RETURNED FOR VALUE
Use BLUE to fill in.
SOCIAL SECURITY NUMBER __________________ (with dashes for STRAWMAN)
This stamp is used for
Revolving Lines of Credit. DTC ROUTING NUMBER ______________________ (Fed. Res. Bank Routing #)
For example: credit cards and
bank lines of credit. ALSO DTC ACCOUNT NUMBER _____________________ (0 + 8 numbers on back of SS card)
USE THIS STAMP FOR THE
1040-V FOR SECTION 2 FOR BY: _____________________________________ (Real Man Autograph)
THE TREASURY PACKET…..may
Need 7 or more lines to fit on 1040-V. DATE: _________________________________
May be best to do by hand or via computer.
************************************************************************
STAMP NAME: AFV Birth Certificate Stamp - - - Hand Print/write, Print by Computer, or Stamp on reverse of birth
certificate for Treasury Packet, lower left to upper right, 45 degree angle. Use a ruler for straight-edge lines.
FONT: Arial 10-point, centered: NON-NEGOTIABLE CHARGEBACK
Stamp is in red.
Use BLUE to fill in. OFFICE HOLDER SECRETARY OF THE TREASURY

I ACCEPT FOR VALUE ALL RELATED ENDORSEMENTS IN ACCORDANCE WITH UCC-3-419, HJR-192, AND PUBLIC LAW 73-10.

CHARGE MY PRIVATE UCC CONTRACT TRUST ACCOUNT EXEMPTION IDENTIFICATION NUMBER FOR THE
REGISTRATION FEES AND COMMAND THE MEMORY OF THE FOLLOWING:
Read what the
Fed. Res. Bank Routing # SOCIAL SECURITY NUMBER ______________________________ (with Dashes for STRAWMAN)
is in the first small AFV
Stamp sidebar of info DTC ROUTING NUMBER _______________________________ (Fed. Res. Bank Routing #)
above.
You’ll use this stamp once. DTC ACCOUNT NUMBER ___________________________ (0+8 numbers on back of SS card)
I suggest you do this “stamp”
by hand for the one-time use. CHARGE THE SAME TO THE DEBTOR’S ORDER OR YOUR ORDER.

PRE-PAID COMMON STOCK / PRIORITY / EXEMPT FROM LEVY

BY: ________________________________________________ DATE: _______________________

(Real Man Autograph)
 AGENCY MAILING LIST

As a convenience, the following 4 pages have been formatted for printing labels. The label
specifications are as follows:

LABEL BRAND: Avery

LARGE LABEL MODEL: 5263 (Qty. 250)

LARGE LABEL SIZE: 2” X 4”

SMALL LABEL MODEL: 5160 (Qty. 250)

SMALL LABEL SIZE: 1” X 2 5/8 ”

PRINTING INSTRUCTIONS:

1. Purchase label paper at your local office supply store according to above
specifications.
2. Insert label paper into your local printer.
3. Select to print appropriate page numbers of this document for the large or small
labels you want to print out.

HEADS UP! BEWARE CAUTION

Before you use address labels on your envelopes with $21.00 postage stamps on
them, and the Return Green Cards, check with your post office because there are
some post offices which will no longer mail a Registered envelope with a stick-on
label. The addresses MUST BE hand addressed because there are too many incidents
where someone is tearing off the labels and the mail becomes undeliverable. I do
NOT understand how this can happen when a registered mail item needs to be
documented with every connection of delivery/receipt. But people have sent emails
saying their post office will no longer accept Registered Mail items with labels. So it’s
just something to know about and check before you use a label and also put the $21
of postage stamps on your envelopes.

ALSO, a note regarding the PS Form 3811 Green Cards: In #2 (Article Number),
always write the label number in this line BEFORE you put the long, thin, sticky, peel-
off number strip in #2. ALSO, write the number on the other (front) side under
“United States Postal Service.” The card should be addressed: Your Name, c/o
Notary’s Name, c/o Notary’s Address, Notary’s City – State – Zip. ALSO, in #1 along
the bottom, black line, put something like: (Your initials, BPN-006, 10-15-09) so you
know which file it’s for. Check “Registered” in #3. Make a copy of front and back,
before sticking on envelope & mailing, and upon return.
 TIMOTHY F. GEITHNER SOCIAL SECURITY
SECRETARY OF THE TREASURY
DEPARTMENT OF THE TREASURY ADMINISTRATION
1500 PENNSYLVANIA AVENUE N.W. P.O. BOX 33008
WASHINGTON, D.C. 20220 BALTIMORE, MARYLAND 21290-3008

DEPARTMENT OF
FEDERAL RESERVE WINDOW
20TH AND CONSTITUTION AVE N.W. TRANSPORTATION
WASHINGTON, D.C. 20551 RAY LAHOOD, SECRETARY
1200 NEW JERSEY AVENUE S.E.
WASHINGTON, D.C. 20590

UNITED STATES SECURITIES AND UNITED STATES COURT OF

EXCHANGE COMMISSION INTERNATIONAL TRADE
COMMISSION HEADQUARTERS ONE FEDERAL PLAZA
100 F STREET N.E. NEW YORK, NEW YORK 10278-0001
WASHINGTON, DC 20549

UNITED STATES SECURITIES AND

UNITED STATES DEPARTMENT OF
EXCHANGE COMMISSION
RONALD L. CRAWFORD, REGIONAL SECRETARY COMMERCE
OFFICE OF COMPLIANCE INSPECTIONS AND DENNIS F HIGHTOWER, DEPUTY SECRETARY
INVESTIGATIONS 1401 CONSTITUTION AVENUE N W
3475 LENNOX ROAD N.E., SUITE 1000 WASHINGTON, DC 20230
ATLANTA, GEORGIA 30326-1232

UNITED STATES DEPARTMENT OF

DOUGLAS SHULMAN COMMERCE
OFFICE OF THE COMMISSIONER OFFICE OF GENERAL COUNCIL
INTERNAL REVENUE SERVICE DEPARTMENT OF ASSISTANCE AND FINANCE
1111 CONSTITUTION AVENUE N W LITIGATION
14TH AND CONSTITUTION AVENUE N W
WASHINGTON, DC 20224 MAIL STOP 5875 HCHB
WASHINGTON, DC 20230
 ERIC THORSON (YOURUCCFILINGSTATE) SECRETARY OF STATE
U.S. TREASURY – INSPECTOR GENERAL UCC DIVISION
1500 PENNSYLVANIA AVENUE N.W. (ADDRESS)
WASHINGTON, D.C. 20220 (CITY, STATE ZIPCODE)

FRANK Y. NG, OR DESIGNEE (YOUR RESIDENCE STATE)

DEPUTY COMMISSIONER INTERNATIONAL NAME - SECRETARY OF STATE
P.O. BOX 920 (ADDRESS)
BENSALEM, PA. 19020 (CITY, STATE ZIPCODE)

U.S. DEPARTMENT OF
IVY CHESNEY, OR DESIGNEE TRANSPORTATION
ASSISTANT GENERAL COUNSEL FOR
DIRECTOR OF INTERNATIONAL OPERATIONS ENVIRONMENTAL, CIVIL RIGHTS, AND
INTERNAL REVENUE SERVICES GENERAL LAW
1111 CONSTITUTION AVENUE N.W. ROOM W96-304(C-10), U.S.
WASHINGTON, D.C. 20224 M STREET AND NEW JERSEY AVENUE S.E.
WASHINGTON, D.C. 20001

(YOUR RESIDENCE STATE) JUAN CARLOS PUIG MORALES

DEPARTMENT OF TREASURY Internal Revenue Service
(NAME OF TREASURER), STATE TREASURER DEPARTMENT DE HACIENDA
(ADDRESS) P.O. BOX 9024140
(CITY, STATE ZIPCODE) SAN JUAN, PUERTO RICO 00902-414

(YOUR BIRTH STATE)

DEPARTMENT OF HEALTH
AND VITAL STATISTICS
ADDRESS
CITY, STATE ZIP CODE
 First Middle Last First Middle Last First Middle Last
c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US
 TIMOTHY F. GEITHNER
SECRETARY OF THE TREASURY SOCIAL SECURITY ADMINISTRATION FEDERAL RESERVE WINDOW
DEPARTMENT OF THE TREASURY P.O. BOX 33008 20TH AND CONSTITUTION AVE N.W.
1500 PENNSYLVANIA AVENUE N.W. BALTIMORE, MARYLAND 21290-3008 WASHINGTON, D.C. 20551
WASHINGTON, D.C. 20220

DEPARTMENT OF UNITED STATES SECURITIES AND UNITED STATES COURT OF

TRANSPORTATION EXCHANGE COMMISSION INTERNATIONAL TRADE
RAY LAHOOD, SECRETARY COMMISSION HEADQUARTERS ONE FEDERAL PLAZA
1200 NEW JERSEY AVENUE S.E. 100 F STREET N.E. NEW YORK, NEW YORK 10278-0001
WASHINGTON, D.C. 20590 WASHINGTON, D.C. 20549

UNITED STATES SECURITIES AND

EXCHANGE COMMISSION UNITED STATES DEPARTMENT OF DOUGLAS SHULMAN
RONALD L. CRAWFORD, REGIONAL SECRETARY COMMERCE OFFICE OF THE COMMISSIONER
OFFICE OF COMPLIANCE INSPECTIONS AND DENNIS F HIGHTOWER, DEPUTY SECRETARY INTERNAL REVENUE SERVICE
INVESTIGATIONS 1401 CONSTITUTION AVENUE N.W. 1111 CONSTITUTION AVENUE N.W.
3475 LENNOX ROAD N.E., SUITE 1000 WASHINGTON, D.C. 20230 WASHINGTON, D.C. 20224
ATLANTA, GEORGIA 30326-1232
UNITED STATES DEPARTMENT OF (YOUR UCC FILING STATE)
COMMERCE ERIC THORSON
OFFICE OF GENERAL COUNCIL U.S. TREASURY – INSPECTOR GENERAL Secretary of State
DEPARTMENT OF ASSISTANCE AND FINANCE LITIGATION
1500 PENNSYLVANIA AVENUE N.W. UCC DIVISION
14 AND CONSTITUTION AVENUE N.W. ADDRESS
TH

MAIL STOP 5875 HCHB WASHINGTON, D.C. 20220

WASHINGTON, D.C. 20230
CITY, STATE ZIP CODE

FRANK Y. NG, OR DESIGNEE (YOUR RESIDENCE STATE) IVY CHESNEY, OR DESIGNEE

DEPUTY COMMISSIONER INTERNATIONAL DIRECTOR OF INTERNATIONAL OPERATIONS
P.O. BOX 920 (NAME), SECRETARY OF STATE INTERNAL REVENUE SERVICES
BENSALEM, PA. 19020 ADDRESS 1111 CONSTITUTION AVENUE N.W.
CITY, STATE ZIP CODE WASHINGTON, D.C. 20224

U.S. DEPARTMENT OF
TRANSPORTATION (YOUR RESIDENCE STATE) JUAN CARLOS PUIG MORALES
ASSISTANT GENERAL COUNSEL FOR DEPARTMENT OF TREASURY
ENVIRONMENTAL, CIVIL RIGHTS, AND DEPARTMENT DE HACIENDA
(NAME) STATE TREASURER
GENERAL LAW P.O. BOX 9024140
ADDRESS
ROOM W96-304(C-10), U.S. SAN JUAN, PUERTO RICO 00902-414
M STREET AND NEW JERSEY AVENUE S.E. CITY, STATE ZIP CODE

(YOUR BIRTH STATE)

DEPARTMENT OF HEALTH
First Middle Last First Middle Last
c/o Real Man Street Address c/o Real Man Street Address
AND VITAL STATISTICS
City, State; near [Zip] City, State; near [Zip]
ADDRESS
Non-Domestic without the US Non-Domestic without the US
CITY, STATE ZIP CODE

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US

First Middle Last First Middle Last First Middle Last

c/o Real Man Street Address c/o Real Man Street Address c/o Real Man Street Address
City, State; near [Zip] City, State; near [Zip] City, State; near [Zip]
Non-Domestic without the US Non-Domestic without the US Non-Domestic without the US