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ESTATE MONEY ORDER Withdrawal Tracking Number: 1001

Original Issue Date:______________________

Pay to the Order of: United States Treasury for: $ _____________


FOR: DOLLARS
Process from the PATRICK DEVINE – ESTATE Bank
and attached American Treasury “Special Fund” account.
ESTATE Authorized Representative

Memo: Settlement with Third party in Lawful “Debt-Free” Currency of Exchange:


Valid per the American Treasury Laws

ESTATE Routing #: ESTATE EIN Account #: Birth Certificate # 1001

ESTATE MONEY ORDER Withdrawal Tracking Number: 1002


Original Issue Date:______________________

Pay to the Order of: United States Treasury for: $ _____________


FOR: DOLLARS
Process from the PATRICK DEVINE – ESTATE Bank
and attached American Treasury “Special Fund” account.
ESTATE Authorized Representative

Memo: Settlement with Third party in Lawful “Debt-Free” Currency of Exchange:


Valid per the American Treasury Laws

Estate Bank Routing #: ESTATE EIN Account #: Birth Certificate # 1002

ESTATE MONEY ORDER Withdrawal Tracking Number: 1003


Original Issue Date:______________________

Pay to the Order of: United States Treasury for: $ _____________


FOR: DOLLARS

Process from the PATRICK DEVINE – ESTATE Bank


and attached American Treasury “Special Fund” account.
ESTATE Authorized Representative

Memo: Settlement with Third party in Lawful “Debt-Free” Currency of Exchange:


Valid per the American Treasury Laws

Estate Bank Routing #: ESTATE EIN Account #: Birth Certificate # 1003


_______________________________________________ _______________________________________________ _______________________________________________
Authorized Representative Endorsement. Authorized Representative Endorsement. Authorized Representative Endorsement.
For Asset value conversion to Lawful Currency For Asset value conversion to Lawful Currency For Asset value conversion to Lawful Currency

______________________________________________ ______________________________________________ ______________________________________________


THIRD PARTY Representative Endorsement: THIRD PARTY Representative Endorsement: THIRD PARTY Representative Endorsement:
Deposit in to DIRECT EXPRESS ACCOUNT: Deposit in to DIRECT EXPRESS ACCOUNT: Deposit in to DIRECT EXPRESS ACCOUNT:
Bank Routing # ____________ Bank Routing # ____________ Bank Routing # ____________
Account # xxxx-xxxx-xxxx-0000 Account # xxxx-xxxx-xxxx-0000 Account # xxxx-xxxx-xxxx-0000
Or Or Or
Send Check to: Send Check to: Send Check to:

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