The Center for Supportive Bureaucracy

Empowering Clerks Network

PAIN DEED
INDIVIDUAL SUFFERING TITLE (INS-1042C)
This hereby certifies that on this day, ___________ the honorable
___________ has declared ownership of all suffering experienced, inherited,
transferred and purchased in his/her own life during the period from _______ to
_________. Owner description of the pain is the following:
________________________________________
________________________________________
________________________________________
________________________________________
CONFIDENTIAL: FOR OWNER USE ONLY MARK INVESTMENT OPPORTUNITIES IN HEART INK.
GROWTH COMPASSION FAITH RELATIONSHIP WISDOM SPIRITUALISM
CREATIVITY LOVE EXISTENTIALISM OTHER: ___________ OWNER INITIALS ______
Visit www.supportivebureaucracy.org to fill out this form with the assistance of a licensed
Empowering Clerk. (838L) Pain stated above may be released or terminated by owner without
prior notice or consent. According to 424982/2A, memory may be subjective and influenceable.

OWNER
SIGNATURE

Norman Fischer
ECN Commissioner of Compassion

C-115
LM02830

Place official ECN

seal here