You are on page 1of 5

Registered Mail # RR*********US THIS IS A PRIVATE COMMUNICATION BETWEEN THE PARTIES NOTICE TO AGENT IS NOTICE TO PRINCIPAL - NOTICE TO PRINCIPAL

IS NOTICE TO AGENT NOTICE OF DEFAULT IN DISHONOR AND CONSENT TO JUDGMENT Claimant: [Claimant] c/o [CLAIMANT] [Address] [City, State, Zip] Respondent(s): [CFO, DBA, RESPONDENT] c/o [RESPONDENT] [STREET ADDRESS] [CITY, STATE, ZIP] Re: ACCOUNT NO. [#]

Enclosed herein and made a part of: (1) ATTACHMENT A, RECORD OF PRESENTMENT AND FAULT NOTICE, consisting of: a. Certificate of Non-Response dated [Date] (# page(s)); b. Notice of Fault in Dishonor, Opportunity to Cure, dated [Date] (# pages); c. Notice of Tender For Setoff dated [Date] (# page(s)); d. Request Regarding a Statement of Account dated [Date] (# page(s)); e. Certificate of Non-Response dated [Date] (# page(s)); f. Notice to Setoff Accounts dated [Date] (# page(s)); g. Affidavit of Service dated [Date] (# page(s)); h. USPS Form 3806, Receipt for Registered Mail, dated May 28, 2010 (1 page); i. Affidavit of Service dated [Date] (# page(s)); j. USPS Form 3806, Receipt for Registered Mail, dated May 28, 2010 (1 page); k. Affidavit of Service dated [Date] (# page(s)); and l. USPS Form 3806, Receipt for Registered Mail, dated June 30, 2010 (1 page).

STATEMENT OF FACTS: 1. On April 23, 2010, John Henry Doe, hereinafter Trustor, made presentment of a NOTICE TO SETOFF ACCOUNTS, MORTGAGE STATEMENT OF ACCOUNT, PRIVATE REGISTERED SETOFF BOND, and I.R.S.FORM 1040-V, hereinafter Tender, a record of which is attached hereto and incorporated herein in its entirety as Attachment A, to IRS Technical Support Division, hereinafter Tender Agent, for the setoff, settlement, and closure of Account No. 1000000201, hereinafter Account, sent via USPS Registered Mail, Article No. RR111222333US, by Cindy Smith, Notary Public, hereinafter Notary, as evidenced by the NOTARYS CERTIFICATE OF SERVICE dated

NOTARYS CERTIFICATE OF SERVICE

Page 1 of 2

April 6, 2010, a record of which is attached hereto and incorporated herein in its entirety as Attachment A. 2. On April 9, 2010, United States Postal Service, hereinafter Carrier, delivered the Tender to the Tender Agent. 3. On April 17, 2010 the Tender Agent accepted the Tender for the settlement of the Account, as evidenced by the CERTIFICATE OF NON-RESPONSE dated April 17, 2010, a record of which is attached hereto as Attachment A 4. On April 17, 2010, John Henry Doe, hereinafter Principal, made presentment of a NOTICE OF TENDER FOR SETOFF and a REQUEST REGARDING A STATEMENT OF ACCOUNT, hereinafter Presentment, to JACK JONES, CHIEF FINANCIAL OFFICER, ABC BANK, N.A., hereinafter Respondent A, sent via USPS Express Mail, Article No. EB111222333US, by the Notary, as evidenced by the NOTARYS CERTIFICATE OF SERVICE dated April 17, 2010, a record of which is attached hereto as Attachment A. 5. On April 17, 2010, John Henry Doe, hereinafter Principal, made presentment of the Presentment to R.K. ARNOLD, MORTGAGE ELECTRONIC REGISTRATION SYSTEMS, INC, hereinafter Respondent B, sent via USPS Express Mail, Article Nos. EB111222333US and EB111222444US, by the Notary, as evidenced by the NOTARYS CERTIFICATE OF SERVICE dated April 17, 2010, a record of which is attached hereto as Attachment A. 6. On April 19, 2010, the Carrier delivered the Presentment to the Respondent A. 7. On April 28, 2010 Respondent A and Respondent B, severally hereinafter Respondents, accepted the terms and provisions of the Presentment, as evidenced by the CERTIFICATE OF NON-RESPONSE dated April 28, 2010, a record of which is attached hereto as Attachment A. 8. Respondents failure to sufficiently respond or timely honor the Presentment, by the terms of the Presentment, constitutes Respondents acceptance and approval of the REQUEST REGARDING A STATEMENT OF ACCOUNT contained therein. 9. As of April 28, 2010 neither the Principal nor the Notary, have received sufficient response to the Presentment, thereby placing the Respondents at fault, as evidenced by the CERTIFICATE OF NON-RESPONSE dated April 28, 2010, and the CERTIFICATE OF NON-PERFORMANCE dated April 28, 2010, a record of which is attached hereto as Attachment A. 10. On June 30, 2010 Principal made presentment of a NOTICE OF FAULT IN DISHONOR, OPPORTUNITY TO CURE to the Respondents, dated April 28, 2010, hereinafter Fault Notice, a record of which is attached hereto as Attachment A, sent via USPS Registered Mail Article Nos. RR222333444US and RR222333555US, by the Notary, as evidenced by the NOTARYS CERTIFICATE OF SERVICE dated April 28, 2010, a record of which is attached hereto as Attachment A. 11. As of May 9, 2010 neither the Principal nor the Notary, received sufficient response to the Presentment or the Fault Notice, from the Respondents, as evidenced by the CERTIFICATE OF NON-RESPONSE/NON-PERFORMANCE dated May 9, 2010, a record of which is attached hereto as Attachment A. 12. Respondents failure to perform by the terms of the Presentment constitutes Respondents acceptance and approval of the granting and conveying of a Specific

NOTARYS CERTIFICATE OF SERVICE

Page 2 of 2

Power of Attorney to the Principal to perform the duties of the Respondents stipulated therein. 13. Respondents failure to perform by the terms of the Fault Notice constitutes Respondents acceptance and approval of the granting and conveying of a Specific Power of Attorney to the Principal to perform the duties of the Respondents stipulated therein. 14. Respondents failure to sufficiently respond or timely honor the Fault Notice, by the terms of the Fault Notice, constitutes Respondents acceptance and approval of the REQUEST REGARDING A STATEMENT OF ACCOUNT incorporated with the Presentment. 15. Respondents acceptance and approval of the REQUEST REGARDING A STATEMENT OF ACCOUNT constitutes Respondents agreement to the stipulated aggregate amount of unpaid obligations being Zero ($0.00) and 00/100 dollars. 16. Respondent has defaulted. 17. As an operation of law, Respondents by dishonor of the Presentment and the Fault Notice has created a default.

DEFAULT: For the Respondents failure to honor the Presentment and Fault Notice places the Respondents in default. For the course of dealing, set forth herein, with the Respondents failure, refusal, or neglect in the presentment of a verified response to the Presentment and Fault Notice, constitutes the Respondents failure to perform in good faith and the Respondents acquiescence and tacit agreement with all terms, conditions and stipulations set forth within this Notice of Default in Dishonor (Consent to Judgment), the Presentment, and the Fault Notice. Therefore this matter is deemed res judicata and stare decisis. Of this presentment take due Notice and heed, and govern yourself accordingly. This FINAL EXPRESSION IN A RECORD is intended as a complete and exclusive statement of the terms of the agreement between the parties.

IN WITNESS WHEREOF I hereunto set my hand and seal on this [Day] day of [Month], 2013 and hereby certify all the statements made above are true, correct and complete.

By: _________________________________ (Seal) [Claimant], Accommodating Party

NOTARYS CERTIFICATE OF SERVICE

Page 3 of 2

JURAT / ACKNOWLEDGMENT State of [STATE] ) [COUNTY] County ) On this day and date of ___________________, _________________________, 2013 A.D., [Claimant] did personally appear before me, is known to be the natural woman or man operating in the requisite capacity for signature described herein, who executed the foregoing, acknowledged the contents thereof; and executed the same as her or him free act and deed. Subscribed and agreed to before the undersigned.

____________________________________________ Notary Signature

Seal/Stamp My commission expires:_______________

ATTACHMENT A RECORD OF PRESENTMENT AND FAULT NOTICE

NOTARYS CERTIFICATE OF SERVICE

Page 4 of 2

FOR: NOTICE OF DEFAULT IN DISHONOR, CONSENT TO JUDGMENT # RR829832996US This section, Attachment A, includes: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. Certificate of Non-Response/Non-Performance dated July 12, 2010 (1 page); Certificate of Non-Response dated June 30, 2010 (1 page); Certificate of Non-Performance dated June 30, 2010 (1 page); Notice of Fault in Dishonor, Opportunity to Cure, dated June 30, 2010 (3 pages); Notice of Tender For Setoff dated May 28, 2010 (2 pages); Request Regarding a Statement of Account dated May 28, 2010 (1 page); Certificate of Non-Response dated May 28, 2010 (1 page); Notice to Setoff Accounts dated April 22, 2010 (1 page); Mortgage Statement of Account/Money Order dated April 22, 2010 (2 pages); I.R.S. Form 1040-V, Payment Voucher (2 pages); Notarys Certificate of Service dated April 23, 2010 (1 page); USPS Form 3806, Receipt for Registered Mail, dated May 28, 2010 (1 page); Notarys Certificate of Service dated May 28, 2010 (1 page); USPS Form 3806, Receipt for Registered Mail, dated May 28, 2010 (1 page); USPS Form 3811, Domestic Return Receipt, dated June 4, 2010 (1 page); Notarys Certificate of Service dated June 30, 2010 (1 page); and USPS Form 3806, Receipt for Registered Mail, dated June 30, 2010 (1 page).

This section includes a total of [.] pages, not inclusive of this page.

NOTARYS CERTIFICATE OF SERVICE

Page 5 of 2

You might also like