Date: Today’s Date, 2021

STEVEN MNUCHIN– Secretary of the Treasury, or his successor

Department of the Treasury
1500 Pennsylvania Ave. NW
Washington, DC 20220
Certified Mail Article Number <CertMailNum>

BONDED CERTIFIED BILL OF EXCHANGE IN ACCORD WITH PUBLIC LAW 48, 48 stat. 112

NOT SUBJECT TO NEGOTIABILITY

RE: CHARGEBACK of PERSONAL UCC CONTRACT TRUST ACCRUAL

Dear Mr. Mnuchin, Secretary-in-charge:

Enclosed are documents (copies) from examination of the Undersigned’s Commercial Agreements, which are
listed on the enclosed (accounting), with Receipts and other evidence that have been accepted for value, all
related endorsements front and back, to include those in accord with U.C.C. § 3-419. The total amount of this
BONDED REGISTERED BILL OF EXCHANGE enclosed is $________________.

Please Charge-back the Undersigned’s UCC Contract Trust Account, # SEE UCC-1 CertMailNum-EIN, for
the same value, and charge the account for the fees necessary for securing and registration (for the priority
exchange for the tax exemption to discharge the public liability) of the personal possessions, and command
Memory of the account to charge the same to the Debtor’s Order or your Order.

This POSTED Certified Trust Accrual, which is part of the Undersigned’s tax estimate, is directed for use
(priority) for the Republic (Article IV, Section IV of the original United States Constitution) in accord with
public policy HJR 192, (discharge of the public debt) through adjustment and setoff, when authorized.

Mr. STEVEN MNUCHIN, Secretary-in-charge and/or your Deputy-in-charge, are to take the Undersigned’s
acceptance (BA), this Article Seven receipt, in exchange for the tax exemption priority. This BONDED
REGISTERED BILL OF EXCHANGE, in accord with HJR-192, Public Law § 73-10, and Public Law 48 (48
stat. 112), is hereby presented for the receiver to the Federal Window for settlement (EFT), which must be
within the three (3) day Truth-in-Lending time (Reg. Z).

With this POSTED transaction the CHARGEBACK charges documented by the enclosed forms, for use by the
Republic, is complete.

Very truly,
ATTACHED INVOICE NUMBERS:

_______birth certificate number_____________ ______________________________________

_______________________________________ Your Name Here, Secured Party
Employer Identification # 123456789
c/o 1234 Your Address Lane
City, State Republic [12345]
Bond # BACK OF Social Security card
Pre-paid – Preferred Stock
Priority - Exempt from Levy