[First Name]: of the [Last Name] Family Willowhale Adversane Lane Adversane West Sussex RH14 9JN (01403)7834563

Monday, January 18, 2010 Ref [YOUR REF] & Case [Your Council Tax Case Number From Summons]
Corporate [Your COUNTY Council] County Council d/b/a [Your District Council] District Council

Vs [First Name]: of the [Last Name] Family court hearing [Date of Hearing] Statutory Declaration Proof of Claim. To the Clerk I [First Name]: of the [Last Name] Family of the above address do solemly declare as follows 1 That I am exercising my right under common law and that I have not entered into any contract with the corporate business known as THE MAGISTRATES COURT [TOWN] and would therefore like to see proof of claim what Lawful Jurisdiction the courts hold over me under Common Law. 2 I have never nor shall ever enter into any contract or statute law with the Corporate business known as [Your County Council] d/b/a [Your District Council] and so therefore would like to see proof of claim that [Your County Council] d/b/a [Your District Council] have any LAWFUL JURISDICTION under Common Law to ask for monies from [First Name]: of the [Last Name] Family under the description of Council Tax. 3 I have never nor shall ever enter into any contract or statute law with the Corporate business known as [Your County Council] d/b/a [Your District Council] on the night of [Date Of Issue of Council Tax Bill] and so therefore would like to see proof of claim that [Your

County Council] d/b/a [Your District Council] had any LAWFUL JURISDICTION under Common Law to accuse me of being a person liable for council tax. 4 I have never nor shall ever enter into any contract or statute law with the Local Government Finance Act 1992 or the Statutory Instrument enacted on the 1st April 1993 under the aforementioned primary legislation therefore would like to see proof of claim that [First Name]: of the [Last Name] had had entered into a contract with the Government Finance Act 1992 or the Statutory Instrument enacted on the 1st April 1993 under the aforementioned primary legislation. 5 I have never nor shall ever enter into any contract or statute law with the Corporate Run for profit business known as [Your County Council] d/b/a [Your District Council] on the [Date Of Issue of Council Tax Bill] therefore [First Name]: of the [Last Name] would like to see proof of claim that [Your County Council] d/b/a [Your District Council] had any LAWFUL JURISDICTION under Common Law to make such demands upon the human being known as [First Name]: of the [Last Name] family by issuing a bill in the sum of [Amount in Numbers] ([Amount in words]). 6 I have never nor shall ever enter into any contract or statute law with the Corporate Run for profit business known as [Your County Council] d/b/a [Your District Council] on the morning of [Date Morning after date of issue of Council Tax Bill] therefore [First Name]: of the [Last Name] would like to see proof of claim that Sergeant 2482 McMcvety had any LAWFUL JURISDICTION under Common Law to threaten [First Name]: of the [Last Name] family with having to appear before the corporate run for profit business [TOWN] MAGISTRATES, and failing to do so then [First Name]: of the [Last Name] MAY commit an offence and be fined, imprisoned or both. Failure to provide proof of claims will mean that you accept that no contracts were entered into and the [First Name]: of the [Last Name] reserves the right to dismiss [Town] Magistrates Court from its duty and [First Name]: of the [Last Name] will waive all rights and benefits that the courts hold over him. AND I MAKE this solemn declaration conscientiously believing the same to be true and by the virtue of the provisions of the Statutory Declarations Act 1835

Declared by the human known as [First Name]: of the [Last Name]

Signed______________________________________Date__________________ Before me Solicitor/Commissioner for oaths

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Date