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NOTICE TO SETOFF ACCOUNTS

Notice by: John Henry Doe, Principal


c/o Cindy Smith, Notary Public
1234 Main Street
Huntington Beach, California 92648

Date of Notice: 6 April 2010

Notice for: IRS Technical Support Division


c/o Treasury UCC Contract Trust
Internal Revenue Service
1500 Pennsylvania Avenue, N.W.
Washington, D.C. 20220

Service by: Registered Mail Article No. RR 111 222 333 US, with return receipt

In the matter of: Enclosed tender for setoff

Please find enclosed, the following instruments:

1. original Notice of State Income Tax Due, issued by California Franchise Tax Board and dated March 25, 2010,
duly indorsed as follows:
ACCEPTED FOR VALUE RETURNED FOR VALUE
EXEMPT FROM LEVY PREPAID COMMON STOCK
DISCHARGE ALL PRESENTMENTS AND RELATED FEES
ADJUST THE BALANCE TO ZERO
PRIVATE PREPAID TREASURY EXEMPTION # 123456789
CHARGE THE SAME TO: JOHN H DOE 123-45-6789
"(signature) (date)"; and

2. original I.R.S. Form 1040-V, Payment Voucher, duly indorsed as follows:


ACCEPTED FOR VALUE RETURNED FOR VALUE
EXEMPT FROM LEVY PREPAID COMMON STOCK
DISCHARGE ALL PRESENTMENTS AND RELATED FEES
ADJUST THE BALANCE TO ZERO
PRIVATE PREPAID TREASURY EXEMPTION # 123456789
CHARGE THE SAME TO: JOHN H DOE 123-45-6789
"(signature) (date)"; and

These instruments are being tendered by John Henry Doe, hereinafter Principal, for the set off of California
Franchise Tax Board Account No. 222-00100-00, and are to be used to affect debit and credit accounting transactions
for the settlement and closure of said account. If any of the enclosed instruments contain any defects or are
incorrect, incomplete, or inaccurate, please return the same to the Principal via the Notary Public at the address
shown above within 10 days from the date of receipt.

Please exercise ordinary care, as the party entitled to enforce these instruments, to ensure that all debit or credit
transactions ledgered to accounts 222-00100-00, and JOHN H DOE 123-45-6789 are done so in the best interest of
the United States Treasury.

Thank you for your consideration, and I look forward to a relationship that is mutually beneficial to all parties
involved.

By: ___________________________________________________
John Henry Doe, Principal
NOTARYS CERTIFICATE OF SERVICE
It is hereby certified, that on the date noted below, the undersigned Notary Public mailed to:

IRS Technical Support Division


c/o Treasury UCC Contract Trust
Internal Revenue Service
1500 Pennsylvania Avenue, N.W.
Washington, D.C. 20220

hereinafter, Recipient, the documents and sundry papers pertaining to the Recipient, regarding
SETOFF OF ACCOUNT NO. 123-00-0001
______________________________________ as follows:

1. NOTICE TO SETOFF ACCOUNTS, issued by John Henry Doe and dated April 6, 2010 (2 pages);
2. NOTICE OF STATE INCOME TAX DUE, issued by California Franchise Tax Board and dated March
25, 2010, with bankers acceptance indorsement on front page and reverse page of leaf (2
pages);
3. I.R.S. FORM 1040-V, PAYMENT VOUCHER, with bankers acceptance indorsement on reverse
page of leaf, dated April 6, 2010 and issued for account JOHN H DOE 123-45-6789 (2
pages);
4. reference copy of this Notarys Certificate of Service (1 page) (signed original on
file),

Seven (7)
a total of _____________________ pages,

by Registered Mail No.RB 100 000 000 US


________________________________ Return Receipt attached by placing same in
a postpaid envelope properly addressed to Recipient at the said address and depositing same at an official
depository under the exclusive face and custody of the U.S. Postal Service within the State of California.

__________________________________________ April 6, 2010


_____________________ (Seal)
NOTARY PUBLIC DATE

My commission expires:August 24, 2010


_____________________________ (Stamp)

Cindy Smith, Notary Public


1234 Main Street
Huntington Beach, California 92648

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