CONVEYANCE BOND

County )
) Asseveration
Republic )
)
United States of America )

L.S______________________
Signed only in correct public capacity
As beneficiary to the original jurisdiction.

NOTICE OF SURETY ACT AND BOND

KNOW ALL MEN BY THESE PRESENTS, I, OfferorFullName, Principle, surety,

guarantor, a free Man/Woman upon the Free soil of this republic, state that I am of legal
age, competent to testify, have personal first hand knowledge of the truths and facts
herein being true, correct, complete, certain and not misleading.

1. I, OfferorFullName ,of my own free will and accord, in the presence of the Almighty
God, in good conscience, do willingly undertake to act as surty, to pledge and provide
private bond in the amount of twenty one dollars in silver coinage, .9000 fine, minted by
the American Treasury, united States of America, pre-1933 issue, Lawful coin dollars of
the united States of America held by the undersigned.
2. This bond is to the credit of the private party listed hereon, My-Full; Name, as full
faith and credit guarantee under Seal in Lawful specie money of account of the united
States of America to any Lawful Bill in Redemption duly presented, to wit:
3. The Bill of Redemtion is a tender as set-off for any alleged contract, agreement,
consent, assent purportedly held, as an obligation or duty against My-Full; Name so as to
cause an imputed disability or presumption against the capacity, Rights and powers of
My-Full; Name. The specific intent of the bond under seal is to establish, by witness of
the undersigned, the good credit in Lawful money specie of My-Full; Name.
I, OfferorFullName, do herby make this surety, pledge, bond under My seal as full faith
and credit guarantee under Seal in Lawful money of account of the united States of
America, to any Lawful Bill duly presented to the undersigned, in the matter of correct
public judicial actions in the forum of Original Rules, Original Jurisdiction, for the
benefit and credit of the particular private party listed above.

The intent of the bond, under Seal, is to establish, by witness of the undersigned, the good
credit, in the sum certain amount of at least twenty one dollars in silver coinage, .
9000fine, minted by the American Treasury, of the united States of America, available to
bond the actions of the private party listed above. Further, in reservation of Rights under
Original Jurisdiction, Original Rules, My-Full; Name has a bond in tender of twenty one
silver dollars, Coinage Act of A.D 1792, Bond of Identity and Character as proof positive,
competent evidence, that My-Full; Name cannot be bankrupt, the causa debeni, cannot be
under the doctrine of cession bonorum, or a forrma pauperis, dolus trust.
The life of this bond is for a period of one year from date below, whereby, by the
signature of OfferorFullName , surety, guarantor, hereon confirms, attests, affirms this
bond.

Done this the ___ day of the_____month, Anno Domini, in the year of our Creator, Two
thousand______

{SEAL}

L.S______________________No Dolus
Signed only in correct public capacity
As beneficiary to the original jurisdiction

STATE OF

COUNTY OF

Before me, a notary public in and for the said County and State, personally appeared the
above named OfferorFullName ,who acknowledged that he/she did sign the foregoing
instrument and that the same is his/her free and voluntary act and deed.

IN TESTIMONY WHEREOF, I have hereunto set my havd and official seal this ___day
of ________ 20___.

____________________
Notary Public
{SEAL}
My commission expires:

L.S.__________________________No Dolus