Verified Notice of Tender of Payment

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Verified Notice of Tender of Payment

Date of Notice: ______________

Notice by: John H. Doe, AR for JOHN H. DOE


c/o 123 Main Street, Anytown, Utah 84770
All rights in commerce are explicitly under reserve and without recourse.

Notice for: Clerk of the USDC


123 Main, Salt Lake City, Utah 84101
via Certified Mail # _______________________________

Reference: Judge’s Order issued on ___________ Case No. ______________

Pursuant to Judge Smith’s Order issued on ___________ , instructing JOHN H. DOE to pay a debt
of $1,000.00 to the Clerk of the USDC, and in accord with current Public Policy at House Joint Resolution
192 passed by the 73rd Congress of the United States, 1st session on June 5, 1933 at 4:40 P.M., hereinafter
referred to as “HJR 192”, with said resolution having never been repealed and still being in full force and
effect, and in accord with both the Uniform Commercial Code and the Utah Code Annotated concerning
the discharge of debts, JOHN H. DOE acting in good faith, with clean hands and at arm’s length, is hereby
and herein tendering payment of a debt in the amount of $1,000.00 in full compliance and full satisfaction
of said Order, issued on _____________ instructing JOHN H. DOE to pay a debt.

In as much as no lawful money of account exists in circulation, and pursuant to current Public
Policy at HJR 192, JOHN H. DOE has no money with which to pay a debt, he has had to resort to tendering
a negotiable instrument, pursuant to the Uniform Commercial Code at Article 3, Part 6, Section 3-603, and
the UCA 70A-3-104 in order to be in compliance with Judge Smith’s Order, issued on ____________ ,
instructing JOHN H. DOE to pay a debt.

As you will note, pursuant to the UCC Article 3, Part 1, Section 3-104 and the UCA 70A-3-104 ,
the attached promissory note is a negotiable instrument and clearly satisfies the requirements of Judge
Smith’s Order, issued __________________ , instructing JOHN H. DOE to pay a debt. Said promissory
note is being tendered in good faith, with clean hands and at arm’s length, and is not a dishonor of said
Order.

Please return receipt of tender to the above address.

Verification: I, John H. Doe, upon my own unlimited commercial liability do affirm and say that I
have read the above document and do know the contents to be true, correct, and complete, and not
misleading, the truth, the whole truth, and nothing by the truth.

_______________________________ __________
Winston Shrout, authorized representative for date

Attachment: Negotiable instrument in the form of a promissory note, numbered 12345, signed in blue
ink, dated ______________ , in the amount of $1,000.00, payable to Clerk of USDC, being due and
payable on or after September 23, 2004, at 123 Main Street, Anywhere, Utah.

Respectfully served,
JOHN H. DOE

By: _____________________________
John H. Doe, authorized representative for JOHN H. DOE

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