4 Service Affirmation

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SERVICE AFFIRMATION UNDER SEAL OF TWO WITNESSES

Notice to Respondeat Inferior is Notice to Respondeat Superior

We, hereinafter, the undersigned, being of the age of consent, stable of mind and competent to testify,
having firsthand knowledge of the living being of whose presentment we wish to solemnly affirm, do by our own
free will, act, and deed, “out of the mouths of two or more,” establish the facts, as set forth herein, to wit:

PLAIN STATEMENT ABOUT THE FACTS: (a) For Resolving a Matter it must be expressed (b) In Commerce
Truth is Sovereign; (c) Truth is expressed in the Form of an Affirmation; (d) An Unrebutted Affirmation stands as
Truth in Commerce; (e) An Unrebutted Affirmation becomes the judgment in Commerce; (f) A Truth
Affirmation, under Commercial Law, can only be satisfied by a Rebuttal about the Truth Affirmation, by
payment, by agreement, by resolution by a grand jury according by the rules for Common Law.

It is hereby verified, that on the date noted below, the undersigned did witness yourfirst yourmiddle:
house of YourLast, hereinafter, claimant, come before Us with the following documents and sundry papers issued
by claimant otherwise and herein identified as follows:

1. Letter from Debt Collectors, Inc. requesting settlement of Alleged Account: 012345678 for
Alleged Amount: $10,000.00, dated January 7, 2013, 1 leaf;
2. Notice of Claimant's Offer to Perform Upon Validation of Debt, dated January 5, 2013, 2 leaves;
3. Debt Collector Disclosure Statement, dated January 5, 2013, 3 leaves;
4. reference copy of this Affirmation of Service Under Seal of Two Witnesses (signed original on
file).

then place the same documents into a postpaid envelope properly addressed to:

Bob Smith
c/o Chief Financial Officer, Bob Smith
Debt Collectors Inc.
123 Duress Road
DebtCity, DebtState; near [12345]

hereinafter, “Recipient”, and seal the same envelope and entrust it to us for post to Recipient by Registered Mail
Number RE 000 000 000 US, Return Receipt attached for deposit at an official depository under the exclusive
face and custody of the United States Postal Service within the State of YourState.

We, the undersigned, did witness the living being, known to us as yourfirst yourmiddle: house of
YourLast, place their thumb print hereon in agreement with the facts stated herein. We have seen no evidence to
dispute that said thumb print represents the physical being known to us as yourfirst yourmiddle: house of
YourLast, and believe that none exists.

Dated this _________________ day of the month of ____________________, Two Thousand and Thirteen.

(seal)

We, the undersigned, do hereby certify the foregoing to be the truth, the whole truth and nothing but the
truth as we know it to be. By our own free will act and deed by our hand and word do hereby establish the facts.

(seal)

(seal)

Leaf 1 of 1 Service Affirmation Under Seal of Two Witnesses

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