<Your Name>

<Address 1>
<Address 2>
<Date>


<Name>
<Company>
<Address 1>
<Address 2>
<Phone>

Re: Account #: < >

Dear <Name or Company>-

This letter is in response to a letter I received from your company regarding an alleged debt. I
agree to pay any financial obligation I may lawfully owe, on the condition you provide the
following proof of debt:

1) The accounting of the alleged loan and documentation of prior title, ownership, and rights to
the funds loaned, and documentation of the history and origin of those funds (please provide
verification through audit certification of debt entry in accordance with GAAP, IFRS, Basel III,
and UNCITRAL conventions);

2) An accurate accounting of all payments and charges;

3) A signed invoice; and

4) A copy of the lawful contract binding both parties.

Please remit, with a true and certified copy of the complete and final forensic audit trail of the
account referenced above, within 30 days of receipt of this letter, along with a copy of your
license, registrations, oath and bond in accordance with <your state> Statute, Tax Codes, and
Federal Trade Commission enforcement policies. If that does not happen I will consider the
account settled and the alleged debt fully discharged.

This is a request for validation made pursuant to the Fair Debt Collection Practices Act. Please
be advised that by contacting me again after receipt of this notice without providing procedurally
proper validation of the alleged debt constitutes the use of interstate communications in a scheme
of fraud by advancing a writing which you know is false, with the intention that others rely on the
written communication to their detriment.

Disputing the debt,
Without prejudice,
UCC 1-308,


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