4 Section4

SECTION
FOUR
TABLE OF CONTENTS
SECTION 4: ENFORCEMENT, FORMS & INFORMATION
1. AFFIDAVIT OF NOTARY PRESENTMENT
2. NEGATIVE AVERMENT, OPPORTUNITY TO CURE, & COUNTERCLAIM
3. FIRST NOTICE OF FAULT (Demand for Payment)
4. SECOND NOTICE OF FAULT (Second Demand for Payment)
5. FINAL NOTICE OF DEFAULT (Final Demand for Payment)
6. NIHIL DICIT
(NOTIFICATION OF FINAL DETERMINATION & JUDGMENT)
7. NOTARY AFFIDAVIT OF NON-RESPONSE
8. MARITIME LIEN
9. IRS FORM 3949-A
10. IRS FORM 4490 Proof of Claim

(NOTE: This is used for the NA, 3 Demands, and Nihil Dicit (1ST i pronounced long a; 2nd i
pronounced eh like in set; accent on 2nd syllable of each; so nay hell day set List
appropriate document as item #2 and the number of pages. The Notarys return address is
on the envelope and on the return green card. The Neg. Aver. is sent by Notary Presentment,
$21.00 Registered Mail; the other 4 are sent by Notary Presentment by Certified Mail. Curing
time for the Neg. Aver. is 21 + 3 calendar days. Then you can mail the 1 st fault, wait for the
next 7 calendar days, & on the next/8th day, mail the 2nd; wait 7, on 8th mail the Final; wait 7,
on 8th mail the Nihil Dicit, wait 8 days. Curing is done.)
AFFIDAVIT OF NOTARY PRESENTMENT
CERTIFICATION OF MAILING
State of _____________________________ )
) ss.
County of ___________________________ )
On this _________day of ___________________________, A.D. 20______, for the purpose of verification, I, the
undersigned Notary Public, being commissioned in the County and State noted above, do certify that
John Lee Doe appeared before me with the following documents listed below. I, the undersigned
notary, personally verified that these documents were placed in an envelope and sealed by me. They
were sent by United States Post Office Registered/Certified Mail Receipt number
REGISTERED/CERTIFIED MAIL # to
NAME AND ADDRESS OF THE RECEIVER
Number of Pages
1. NOTARY PRESENTMENT 1
2. AFFIDAVIT OF NEGATIVE AVERMENT, OPPORTUNITY TO CURE, AND COUNTERCLAIM 3
WITNESS my hand and official seal.
__________________________________________________ _____________________________ (Seal)

Notary Public Date
My commission expires: _________________________, 20_______

OPTIONAL: Notary includes LEGAL NOTICE from the file in the EXTRAS folder. See example on the
Faults. Delete this line.
(Check with the procedures of your county as to the inches of empty space required at the top of this
page for recording stamps and info, and the size requirements for margins, font, etc.)
Registered Mail # RR 123 456 789 US

Notice to Agent is Notice to Principal
Notice to Principal is Notice to Agent
IN THE CIRCUIT COURT OF (YOUR) COUNTY
(XYZ BANK), PLAINTIFF CASE # CV08-7
v.
(YOUR STRAWMAN NAME), DEFENDANT
(Your Real Man) Name, Third Party Plaintiff IN ADMIRALTY
v.
(LIST DEFENDANT/S), Third Party Defendant/s
AFFIDAVIT OF SPECIFIC NEGATIVE AVERMENT,

OPPORTUNITY TO CURE, AND COUNTERCLAIM
Comes now John Lee Doe, Third Party Plaintiff, by special visitation and not appearing generally,
before this court seeking a remedy in Admiralty as is provided by The Saving to the Suitors Clause at USC
28 -1333(1). I am standing in my unlimited commercial liability as a Secured Party Creditor and request that
the Third Party Defendants do the same, and waive all of their immunities. I respectfully request the
indulgence of this court as I am not schooled in law. This is provided by the precedent set by Haines vs.
Kerner at 404 U.S. 519.
AS TO COUNT 1: I, John Lee Doe, the Third Party Plaintiff, Secured Party Creditor, a Natural man or
Woman, created by God, Demand that the ( Third Party Defendants) produce their Proof of Claim. I demand
to inspect the "Original Mortgage Note", with wet ink signatures, along with the Title Page that shows
whether or not the mortgage has been satisfied. I believe that the (Mortgage Holder) has sold the original
Note and failed to give credit to my account. This Note was created on my credit, and signature, and was not
an asset of (Mortgage Company or Bank). I believe the Third Party Defendants have not been damaged and
have no legal right to a claim. As you well know, Proof of Claim must be established by law. Only the Original
Mortgage Note will be accepted as proof of claim. If the Third Party Defendants have the original mortgage
note let them bring it forth and offer their Proof of Claim for my inspection. I believe the Third Party
Defendants DO NOT have lawful Proof of Claim and there is no evidence to the contrary. This is Dishonor in
Commerce, Theft, Fraud, Conspiracy, and Racketeering.
AS TO COUNT 2: I, John Lee Doe tendered a lawful note to (Mortgage Holder) to settle this debt.
(Mortgage Holder) has chosen to dishonor my lawful Note and has refused to zero the account. Lawful Money
no longer is available for payment of debt in our economic system. Notes are considered as Legal Tender for
debts, according to the Code. This is a Dishonor in Commerce, Fraud, Theft of Public Funds, Racketeering, and
Conspiracy, and I believe there is no evidence to the contrary.
OPPORTUNITY TO CURE
The Third Party Defendants have 21 calendar days to cure their Dishonor by the following:
1. Dismiss any and all claims against the Third Party Plaintiff, with prejudice and (add your conditions) .
.............
2. Pay all damages as indicated by the counterclaim contained herein with Real Money, Surrender any
and all Public Hazard Bonds, other Bonds, Insurance Policies, 801K, CAFR Funds, etc. as needed to
satisfy counterclaim herein, OR,
3. Prove your claims against me by providing me with lawfully documented evidence that is certified
true and correct, by (Officers of the Court whoever applies in your case), in their unlimited
commercial liability, while Under Oath, On and For the Official Record, under penalties of the law
including Perjury. This evidence must prove your case by a preponderance or the greater weight of
evidence and must answer each and every averment, Point by Point individually. If any and all points
are not answered fully and accompanied by lawfully documented evidence, as provided herein, that
will be Default on the part of the Third Party Defendants. Non-Response according to the conditions
herein will be default. Incomplete answers and/or lack of documented evidence as outlined herein
will be Default. If the Third Party Defendants fail to respond as outlined herein, within 21 calendar
days, this will be Default. Non-Response will be a Self-Executing Confession of Judgment by all Third
Party Defendants, and will be complete agreement with all the statements, terms, and conditions of
this contract. This is a contract in Admiralty. Any officer of the court that interferes or involves
himself/herself with this claim will be added to this claim and become a Third Party Defendant. All
Third Party Defendants are jointly and severally liable for this claim.
COUNTERCLAIM
THE FOLLOWING DAMAGES HAVE BEEN ASESSED AGAINST YOU SHOULD YOU FAIL TO MEET THE
REQUIREMENTS AS PROVIDED IN THE OPPORTUNITY TO CURE CONTAINED HEREIN:
1. Failure to state a claim upon which relief can be granted $1,000,000.00 (One Million US Dollars) per
count, per violation, Per Third Party Defendant.
2. Failure to respond as outlined herein $1,000,000.00 (One Million US Dollars.) per count, per violation,
Per Third Party Defendant.
3. Default by non response or incomplete response $1,000,000.00 (One Million Dollars) per count, per
violation, Per Third Party Defendant.
4. Dishonor In Commerce - $1,000,000.00 (One Million Dollars) per count, per violation, Per Third Party
Defendant.
5. Fraud - $1,000,000.00 (One Million US Dollars) per count, per violation, Per Third Party Defendant.
6. Racketeering - $1,000,000.00 (One Million US Dollars) per count, per violation, Per Third Party
Defendant.
7. Theft of Public Funds -$1,000,000.00 (One Million US Dollars) per count, per violation, Per Third Party
Defendant.
8. Failure to pay Counterclaim in full within (30) Thirty Calendar Days of Default as contained herein.
$1,000,000.00 (One Million US Dollars), per month, and interest of 1.5 % per month compounded daily
for the first (30) Thirty Days from the date of default. After (30) Thirty Days beginning on the (31 st)
Thirty-first Day after Default, the penalties for Failure to pay will increase by $100,000.00 (One Hundred
Thousand Us Dollars Per Day) for each calendar day that this counterclaim is not paid in full, plus
interest. After (90) calendar days, beginning on the 91 st day of the date of Default, the penalties for
Failure to Pay Counterclaim will increase by $1,000,000.00 (One Million US Dollars) per calendar day,
that the Counterclaim is not paid in full, plus interest as indicated herein.
9. All Claims are stated in US Dollars which means that a US Dollar will be defined, for the purposes of this
counterclaim as, a One Ounce Silver coin of .999 fine silver, or the equivalent par value as established by
law or the exchange rate as set by the US Mint, whichever is the higher amount, for a certified One Ounce
Silver Coin at the time of the first day of default as outlined herein, if the claim is to be paid in Federal
Reserve Notes, Federal Reserve notes will only be accepted at Par Value as indicated above.
10. Punitive damages will be assessed as the total amount of the damages as outlined herein times three.
Punitive damages will be added to the original amount of damages.
_____________________________________________________________
John Lee Doe, Secured Party Creditor
Date: _______________________________________________________
(Spell out the month for the Real Man. Delete this line.)
JURAT
State of ________________________________)
) ss.
County of ______________________________ )
The above named Libelant, John Lee Doe, Executive Trustee for JOHN LEE DOE appeared before me, a
Notary, subscribed, sworn to the truth of this contractual AFFIDAVIT OF SPECIFIC NEGATIVE AVERMENT,
OPPORTUNITY TO CURE, AND COUNTERCLAIM.
Under oath this ________day of ______________________________, A.D. 2009
Notary name PRINTED Notary Signature Seal/Stamp
Notary City and State My commission expires

OPTIONAL: Notary includes LEGAL NOTICE from the file in the EXTRAS folder. See example on the
Faults. Delete this line.
NOTE: For Plural, Change ***Libelee to Libelees; lees/lees; verbs;*** Certified Mail # 1234 5678 9009 8765 4321
PRIVATE Notice to Agent is Notice to Principal

THIS IS NOT A PUBLIC COMMUNICATION
YOURRECORDINGCOUNTY COUNTY, YOURRECORDINGSTATE (for judicial NA)

OR Registered Mail # RR 123 456 789 US (for & from administrative NA)
united States of America
SILENCE IS ACQUIESCENCE, AGREEMENT, AND DISHONOR

THIS IS A SELF-EXECUTING CONTRACT
NOTICE OF INTERNATIONAL COMMERCIAL CLAIM WITHIN THE ADMIRALTY

ab initio ADMINISTRATIVE REMEDY
[28 U.S.C. 1333, 1337, 2461 and 2463]
CASE # IF APPLICABLE DATE: Month DD, YYYY
FIRST NOTICE OF FAULT AND

DEMAND FOR PAYMENT
LIBELANT:
John Lee Doe, Trustee, Executive Trustee for the Private Contract Trust known as JOHN LEE DOE
c/o NotaryName, Notary Witness
NOTARY:
NotaryName
NotaryAddress
NotaryCity, NotaryState NotaryZipCode
LIBELEE: (***)
FROM WHOM COLLECTION IS DEMANDED

ADDRESS
CITY, STATE ZIP CODE
This demand for payment is applicable to all successors and assigns.
Libelant is entitled to performance and stipulated damages agreed to by Libelees (***) failure to respond or
rebut Libelants INTERNATIONAL COMMERCIAL CLAIM ab initio ADMINISTRATIVE REMEDY File #
REGISTERED MAIL #, dated DATE OF CLAIM, hereinafter ICC, by Affidavit of Specific Negative Averment,
Opportunity to Cure, and Counterclaim. (Spell out the month for the Real Man.)
FIRST DEMAND FOR PAYMENT AND SETTLEMENT

As per Libelees (***) agreement to damages amounting to the sum certain total listed in the True Bill
accounting of the dishonored ICC in the following amounts, as the terms and conditions did clearly manifest,
this document is a demand for payment of the agreed damages.
DEMAND FOR SETTLEMENT AS PER AGREEMENT

SUM CERTAIN PER AGREEMENT: USD $ AMOUNT OF CLAIM
Libelant reserves the right to amend and correct and adjust the accounting and True Bill to reflect injuries
due to continued trespass.
The sum certain in US Dollars is in numerical parity with the Euro Dollar and any other superior currency
backed by gold. Sum certain may also be paid in any numerical value in gold and equal value in real property
and natural resources, and any agreeable combination of the above.
DEMAND FOR PAYMENT

Libelant grants Libelee (***) three (3) days, exclusive of the date of receipt, to settle by payment of the claims
contained in this document. Failure to settle is a commercial dishonor [UCC3-505]. This is a UCC
CONFIRMATORY WRITING and STATUTE STAPLE and is a perfected contract upon the completion of this
commercial process.
It is mandatory that if Libelee (***) elects (***) to respond to the foregoing, any such response must be done
by delivering payment as stated in Libelants ICC mailing location exactly as shown below:
C/o NotaryName, Notary Witness
NotaryAddress
CONTRACTUAL NOTICE OF DEMAND AND SETTLEMENT

FOR CLOSING OF THE ESCROW
Libelant is moving for settlement [U.C.C. 3-501 and U.C.C. Article 9] causing this NOTICE OF DEMAND FOR
SETTLEMENT service upon the Libelee (***) by Certified Mail. This is a commercial process within the
Admiralty.
Libelee (***) is (***) granted three (3) days [Truth in Lending Act at Regulation Z at 12 CFR and portions of
15 USC], exclusive of the day of service to make full payment of the sum certain as stated above and as
evidenced in Libelants accounting and True Bill.
COMMERCIAL AFFIDAVIT OATH AND VERIFICATION

State of ________________________________________)
) ss. Commercial Oath and Verification
County of _____________________________________ )
I, John Lee Doe, Executive Trustee for JOHN LEE DOE, under my unlimited liability and Commercial
Oath, proceeding in good faith, being of sound mind, having first-hand knowledge, state that the facts
contained herein are true, correct, complete and not misleading, under penalty of International Commercial
Law, so help me, God.

EXPRESS SPECIFIC RESERVATION OF RIGHTS
I explicitly reserve all my natural rights as an American Secured Party Creditor under contract law of
the Divine Creator without prejudice and, without recourse to me. I do not consent to compelled
performance under any contract that I did not enter knowingly, voluntarily and intentionally. I do not accept
the liability of the benefits or privileges of any unrevealed contract or commercial agreement.
By:_______________________________________________________
John Lee Doe, Executive Trustee for the
Private Contract Trust known as JOHN LEE DOE
JURAT
State of ______________________________ )
) ss.
County of _____________________________ )
The above named Libelant, John Lee Doe, Executive Trustee for JOHN LEE DOE appeared before me, a Notary,
subscribed, sworn to the truth of this contractual FIRST NOTICE OF FAULT AND DEMAND FOR PAYMENT AND
SETTLEMENT for closing of the escrow.
Under oath this _______day of _________________________________, A.D. 2009
____________________________________________________
Notary SEAL
My Commission expires__________________________
(NOTE: The following is optional for your Notary, but because some STATES have revoked the Seal and
authority of some Notaries to continue in that capacity, for having notarized documents that are part of this
manual, it is worth consideration to include this NOTICE. See the full Legal Notice in the EXTRAS folder.)
LEGAL NOTICE
The Certifying Notary is an independent contractor and not a party to this claim. In fact the Certifying Notary is a Federal Witness Pursuant
to TITLE 18, PART I, CHAPTER 73, SEC. 1512. Tampering with a witness, victim, or an informant. The Certifying Notary also performs the
functions of a quasi-Postal Inspector under the Homeland Security Act by being compelled to report any violations of the U.S. Postal
regulations as an Officer of the Executive Department. Intimidating a Notary Public under Color of Law is a violation of Title 18, U.S. Code,
Section 242, titled Deprivation of Rights Under Color of Law, which primarily governs police misconduct investigations. This Statute makes
it a crime for any person acting under the Color of Law to willfully deprive any individual residing in the United States and/or United States
of America those rights protected by the Constitution and U.S. laws.

PRIVATE



[28 U.S.C. 1333, 1337, 2461 and 2463]

SECOND NOTICE OF FAULT AND
DEMAND FOR PAYMENT
LIBELANT:
NOTARY:
NotaryName
NotaryAddress
LIBELEE: (***)

ADDRESS
This second demand for payment is applicable to all successors and assigns.
REGISTERED MAIL #, dated DATE OF CLAIM, hereinafter ICC. Additionally, Libelee (***) has (***) failed to
respond to the Libelants FIRST NOTICE OF FAULT AND DEMAND FOR PAYMENT dated DATE OF FIRST
NOTICE OF FAULT. (Example write out the month: October 20, 2009)
SECOND DEMAND FOR PAYMENT AND SETTLEMENT

SECOND DEMAND FOR SETTLEMENT AS PER AGREEMENT

SECOND DEMAND FOR PAYMENT

commercial process.
C/o NotaryName, Notary Witness
NotaryAddress
CONTRACTUAL SECOND NOTICE OF DEMAND AND SETTLEMENT

Libelant is moving for settlement [U.C.C. 3-501 and U.C.C. Article 9] causing this SECOND NOTICE OF FAULT
AND DEMAND FOR SETTLEMENT service upon the Libelee (***) by Certified Mail. This is a commercial
process within the Admiralty.
Libelee (***) is (***) granted three (3) days [Truth in Lending Act at Regulation Z at 12 CFR and portions of

State of ________________________________________)
County of _____________________________________ )


By:_______________________________________________________
JURAT
State of ______________________________ )
) ss.
County of _____________________________ )
subscribed, sworn to the truth of this contractual SECOND NOTICE OF FAULT AND DEMAND FOR PAYMENT AND
____________________________________________________
Notary SEAL
My Commission expires__________________________
LEGAL NOTICE


PRIVATE Notice to Principal is Notice to Agent



[28 U.S.C. 1333, 1337, 2461 and 2463]

FINAL NOTICE OF DEFAULT AND
DEMAND FOR PAYMENT
LIBELANT:
NOTARY:
NotaryName
NotaryAddress
LIBELEE: (***)

ADDRESS
This demand for payment is applicable to all successors and assigns.
REGISTERED MAIL #, dated DATE OF CLAIM, hereinafter ICC. Additionally, Libelee (***) has (***) failed to
respond to Libelants FIRST AND SECOND NOTICES OF FAULT AND DEMAND FOR PAYMENT that were
delivered by Notary Presentment dated DATE OF FIRST NOTICE OF FAULT and DATE OF SECOND NOTICE OF
FAULT, respectively. (Spell out the months in the 3 dates in UpperLowerCase letters.)
FINAL DEMAND FOR PAYMENT AND SETTLEMENT

FINAL DEMAND FOR SETTLEMENT AS PER AGREEMENT

FINAL DEMAND FOR PAYMENT

commercial process.
John Lee Doe, Executive Trustee for the Private Contract Trust known as JOHN LEE DOE
NotaryAddress
CONTRACTUAL FINAL NOTICE OF DEMAND AND SETTLEMENT

Libelant is moving for settlement [U.C.C. 3-501 and U.C.C. Article 9] causing this FINAL NOTICE OF DEFAULT
AND DEMAND FOR SETTLEMENT service upon the Libelee (***) by Certified Mail. This is a commercial
process within the Admiralty.
Libelee (***) is (***) granted Three (3) days [Truth in Lending Act at Regulation Z at 12 CFR and portions of

State of ________________________________________)
County of _____________________________________ )

Executed upon the land at County county, State; Republic, this twenty-third day of the tenth month in
the year of our Lord, two-thousand and nine. Witness my hand and seal.
By:_______________________________________________________
JURAT
State of ______________________________ )
) ss.
County of _____________________________ )
subscribed, sworn to the truth of this contractual FINAL NOTICE OF DEFAULT AND DEMAND FOR PAYMENT AND
__________________________________________________________________
Notary SEAL
My Commission expires_______________________________________
LEGAL NOTICE

NOTE - The following text is a sample. It is NOT a template. Tell your own story!!!
A Notice of Final Determination is a certificate of process. You tell what happened, what was done, that
they were given proper notice in a specified time, and there was no response.
Certified Mail # 1234 5678 9009 8765 4321

LIBELEE: (***)

ADDRESS
NOTICE OF FINAL DETERMINATION AND JUDGMENT IN NIHIL DICIT

Comes now John Lee Doe to this court with the notice of the following facts:
1. On or about DATE, I filed an Affidavit of Specific Negative Averment, Opportunity to Cure, and
Counterclaim into Case Number 123456789. This notice was sent by Registered Mail Receipt # RR
123 456 789 US and was received by Katie Clerk on DATE, per USPS 3811 Return Receipt and you did
not respond.
2. On or about DATE, you were sent a First Notice of Fault and Demand for Payment for payment in the
amount of $123456789 Billion US Dollars. This notice was sent by Certified Mail Receipt # 1234 5678
9009 8765 4321 and was received by Katie Clerk on DATE, per USPS 3811 Return Receipt. You did
not respond.
3. On or about DATE, a Second Notice of Fault and Demand for Payment was sent. This notice was sent
by Certified Mail Receipt # 1234 5678 9009 8765 4321 and was received by Katie Clerk on DATE, per
USPS 3811 Return Receipt You did not respond.
4. On DATE, a Final Notice of Default and Demand for Payment was sent. This notice was sent by
Certified Mail Receipt # 1234 5678 9009 8765 4321 and was received by Katie Clerk on DATE, per
USPS 3811 Return Receipt. You did not respond. You are now in default and damages are past due.
Penalties and interest are accruing daily as is provided by contract.
THIS IS THE FINAL NOTIFICATION AND JUDGMENT. NO OTHER NOTIFICATIONS WILL BE SENT TO YOU.
COLLECTION OF THIS LAWFUL CLAIM, AGAINST YOUR BONDS, INSURANCE POLICIES, 801-K, CAFR FUNDS,
PROPERTIES, OR ANY OTHER SOURCE OF REVENUE TO CURE YOUR DISHONOR IN THE PUBLIC WILL BEGIN
IN THREE BUSINESS DAYS IF THIS CLAIM IS NOT PAID IN FULL. ADDITIONAL CIVIL DAMAGES AND
CRIMINAL CHARGES MAY ALSO BE FORTHCOMING. NON-RESPONSE IS A SELF-EXECUTING POWER OF
ATTORNEY TO FILE LIENS AND ENCUMBERANCES AGAINST ANY AND ALL PROPERTY OF THE LIBELEES.
______________________________________________
John Lee Doe, Libelant
______________________________________________
Date
(NOTE: This is the Notarys report for you . . . . . the one whos doing the Notary Presentment of the
Enforcement Documents. If you want the Notary to annotate any additional information from the
documents, or regarding the sending of the documents, adjust this. For instance, you might want
statements such as: On such & such a date I sent title of document to whomever and I received no
response. Repeat, repeat, for each of the documents, etc.)
NOTARY AFFIDAVIT OF NON-RESPONSE

State of _____________________________ )
) ss.
County of ___________________________ )
On this _________day of ____________________________, A.D. 20______ for the purpose of verification, I, the
undersigned Notary Public, being commissioned in the County of County Name State of State Name
noted above, do certify that I have received no response from the Two Notices of Fault, One Notice of
Default, and a Nihil Dicit that were sent by certified mail to the following recipient(s):
ADD NAMES AND ADDRESSES OF RECIPIENTS

Name of Document, Certified Mail #, Date Sent
____ ____________ ___________________

Notary name PRINTED Notary Signature Seal/Stamp
____ _________________________________________
Notary City and State My commission expires
EXPIRATION DATE: February 12, 2054
THIS SECTION FOR RECORDERS USE ONLY
U.S. DEPARTMENT OF
HOMELAND SECURITY
U.S. COAST GUARD NOTICE OF CLAIM
46 CFR 67.250 OF MARITIME LIEN
REGISTERED MAIL RECEIPT USED TO MAIL THIS CLAIM
1. NAME OF VESSEL 2. UNIQUE IDENTIFIER
U. S. M/V ALL CAPITAL SOCIAL SECURITY NUMBER, BAR CARD NUMBER,
EIN NUMBER, ETC.
NAME OF
LIBELEE RECORDED
3. INSTRUMENT TYPE:
PORT
INTERNATIONAL COMMERCIAL CLAIM BY AFFIDAVIT OF SPECIFIC NEGATIVE AVERMENT
OPPORTUNITY TO CURE AND COUNTERCLAIM # (REGISTERED MAIL # FROM NEGATIVE BOOK
AVERMENT) CASE NUMBER IF APPLICABLE.
PAGE
BY
4. NAME AND ADDRESS OF OWNER OF VESSEL
RAY LAHOOD
US TRANSPORTATION
1200 NEW JERSEY AVE., SE
WASHINGTON, DC 20590
INTEREST OWNED IN VESSEL AFFECTED BY ATTACHED INSTRUMENTS 100%. (100% UNLESS OTHERWISE STATED)
_______________________________
5. NAME AND ADDRESS OF CLAIMANT
Your Real Man Name

c/o RealManAddress
RealManCity, RealManState; near [RealManZipCode]
Non-Domestic without the US
PERCENTAGE OF VESSEL MORTGAGED OR MORTGAGE ASSIGNED 100 %. (100% UNLESS OTHERWISE STATED)
_
6. AMOUNT 7. ALL PROPERTY INCLUDING BUT NOT LIMITED TO: ALL BANK ACCOUNTS, SAFETY DEPOSIT
BOXES, RETIREMENT FUNDS, 801K'S, 401K'S, REAL ESTATE, STOCKS, BONDS, SECURITIES, CASH ON
HAND, JEWELRY, HOUSES, LAND, MOTOR VEHICLES, AUTOMOBILES, MOTORHOMES, AIRCRAFT,
HOUSEHOLD FURNITURE, GUNS, AMMUNITION, COIN COLLECTIONS, ALL COLLECTIBLE ITEMS,
AMOUNT OF CLAIM PLUS INSURANCE POLICIES, CREDIT CARDS, LINES OF CREDIT, YACHTS AND WATERCRAFT, FARM
EQUIPMENT, MACHINERY, TOOLS, EQUIPMENT, HEAVY EQUIPMENT, IMPLEMENTS, BULK GRAINS AND
INTEREST, PENALTIES, AND FEEDS, TACKLE, HARNESSES, LIQUOR, CROPS, FARM ANIMALS, FARM SUPPLIES, BUILDING
ALL FEES MATERIALS, BUSINESSES, OFFICE EQUIPMENT, COMPUTERS, OFFICE SUPPLIES, CORPORATE
ASSETS, WATER RIGHTS, MINERAL RIGHTS, OIL AND GAS RIGHTS, INTELLECTUAL PROPERTY, OR
ANYTHING OF VALUE AS NEEDED TO SATISFY THIS CLAIM.
8. CERTIFICATION AND ATTESTATION:
I (WE) HEREBY CERTIFY THAT THE FACTS RECITED HEREIN ARE TRUE AND CORRECT. I (WE) UNDERSTAND THAT THE U.S. COAST GUARD
WILL RELY ON THOSE RECITATIONS IN INDEXING THE ATTACHED INSTRUMENTS. THE OWNER AND ALL RECORDED MARITIME LIENHOLDERS HAVE
BEEN NOTIFIED BY U.S. MAIL.
SIGNATURE OF CLAIMANT:
__________
Your Signature Here , Claimant

________________________________________________________
State of : ____________________________________________
County of : __________________________________________
SUBSCRIBED AND SWORN ON THE _______ day of December, A.D. 2009:
Seal
__________________________________________________________________________________________________ NOTARY PUBLIC _______________________________________________________________________________________
MY COMMISSION EXPIRES: __________________________________

_______________________________________________
(DATE)

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SECTION

SECTION 4: ENFORCEMENT, FORMS & INFORMATION

1. AFFIDAVIT OF NOTARY PRESENTMENT

2. NEGATIVE AVERMENT, OPPORTUNITY TO CURE, & COUNTERCLAIM

3. FIRST NOTICE OF FAULT (Demand for Payment)

4. SECOND NOTICE OF FAULT (Second Demand for Payment)

5. FINAL NOTICE OF DEFAULT (Final Demand for Payment)

7. NOTARY AFFIDAVIT OF NON-RESPONSE

9. IRS FORM 3949-A

10. IRS FORM 4490 Proof of Claim

AFFIDAVIT OF NOTARY PRESENTMENT

NAME AND ADDRESS OF THE RECEIVER

WITNESS my hand and official seal.

__________________________________________________ _____________________________ (Seal)

My commission expires: _________________________, 20_______

Registered Mail # RR 123 456 789 US

IN THE CIRCUIT COURT OF (YOUR) COUNTY

(XYZ BANK), PLAINTIFF CASE # CV08-7

(YOUR STRAWMAN NAME), DEFENDANT

(Your Real Man) Name, Third Party Plaintiff IN ADMIRALTY

(LIST DEFENDANT/S), Third Party Defendant/s

AFFIDAVIT OF SPECIFIC NEGATIVE AVERMENT,

Under oath this ________day of ______________________________, A.D. 2009

Notary name PRINTED Notary Signature Seal/Stamp

Notary City and State My commission expires

PRIVATE Notice to Agent is Notice to Principal

THIS IS NOT A PUBLIC COMMUNICATION

YOURRECORDINGCOUNTY COUNTY, YOURRECORDINGSTATE (for judicial NA)

SILENCE IS ACQUIESCENCE, AGREEMENT, AND DISHONOR

NOTICE OF INTERNATIONAL COMMERCIAL CLAIM WITHIN THE ADMIRALTY

CASE # IF APPLICABLE DATE: Month DD, YYYY

FIRST NOTICE OF FAULT AND

FROM WHOM COLLECTION IS DEMANDED

This demand for payment is applicable to all successors and assigns.

FIRST DEMAND FOR PAYMENT AND SETTLEMENT

DEMAND FOR SETTLEMENT AS PER AGREEMENT

DEMAND FOR PAYMENT

CONTRACTUAL NOTICE OF DEMAND AND SETTLEMENT

COMMERCIAL AFFIDAVIT OATH AND VERIFICATION

FIRST DEMAND FOR PAYMENT AND SETTLEMENT

Under oath this _______day of _________________________________, A.D. 2009

FIRST DEMAND FOR PAYMENT AND SETTLEMENT

THIS IS NOT A PUBLIC COMMUNICATION

YOURRECORDINGCOUNTY COUNTY, YOURRECORDINGSTATE (for judicial NA)

SILENCE IS ACQUIESCENCE, AGREEMENT, AND DISHONOR

NOTICE OF INTERNATIONAL COMMERCIAL CLAIM WITHIN THE ADMIRALTY

CASE # IF APPLICABLE DATE: Month DD, YYYY

FROM WHOM COLLECTION IS DEMANDED

SECOND DEMAND FOR PAYMENT AND SETTLEMENT

SECOND DEMAND FOR SETTLEMENT AS PER AGREEMENT

SECOND DEMAND FOR PAYMENT

CONTRACTUAL SECOND NOTICE OF DEMAND AND SETTLEMENT

COMMERCIAL AFFIDAVIT OATH AND VERIFICATION

SECOND DEMAND FOR PAYMENT AND SETTLEMENT

SECOND DEMAND FOR PAYMENT AND SETTLEMENT

Under oath this _______day of _________________________________, A.D. 2009

SECOND DEMAND FOR PAYMENT AND SETTLEMENT

Notice to Agent is Notice to Principal

THIS IS NOT A PUBLIC COMMUNICATION

YOURRECORDINGCOUNTY COUNTY, YOURRECORDINGSTATE (for judicial NA)

SILENCE IS ACQUIESCENCE, AGREEMENT, AND DISHONOR

NOTICE OF INTERNATIONAL COMMERCIAL CLAIM WITHIN THE ADMIRALTY

CASE # IF APPLICABLE DATE: Month DD, YYYY

______________________ _ (Seal)

My commission expires: ___________________, 20_

Under oath this day of ______________________, A.D. 2009

Under oath this _day of ___________________________, A.D. 2009

Under oath this _day of ___________________________, A.D. 2009

Under oath this _day of ___________________________, A.D. 2009

___________