Date

To:

CONDITIONAL ACCEPTANCE AND DEBT VERIFICATION NOTICE

Re:

I refer to the ……………..dated ……… and wish to advise that your negotiable
instrument has been accepted for value upon proof of claim, which may be substantiated
by forwarding the following verification of debt details within 3 days (72 hours) of
receipt of this notice to the address listed below.

1. Proof of the existence of an account or contract in the actual flesh and blood name
of ……………, duly signed and witnessed by both parties, (not a unilateral
agreement) and upon which signed page there is reference to the entire agreement.
(Note: …………………. is an artificial entity, a limited liability legal fiction-
trademark which constitutes valuable intellectual property. All rights, title and
interest are reserved.
2. Proof of claim that you are the current holder of the abovementioned original
unaltered debt instrument (not a copy) and that it has not been on-sold to another
party.
3. A copy of the ACTUAL ACCOUNTING whereby …………..has incurred a loss
of the alleged debt.
4. An INVOICE (not a statement) for any amount of money allegedly owed to ……
…………….by ……………………...
5. Proof that there is any lawful money in circulation, backed by anything of value
with which to pay, along with the agreed specification of the unit of measure.

Please forward all correspondence to:

……………………………….
………………………………..

DISCLAIMER

Please note: Incorrectly addressed mail shall be returned unopened and unread. Any and all correspondence from this point must be by
mail only. ………………… does not authorise the recording of his voice, at any time for any purpose, nor does he consent to being
contacted by telephone, and shall enforce his copyright rights in all instances such as copyright infringement or trademark violation.
No authorisation for the use of ……………..™ is implied, granted or permitted.
……………………™ agrees to hold harmless ………………… for all claims and liability under private contract between the parties.