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RTG/webroot/GuestForms/RTG-AAAF-Notice-AFFIANT-AFFIDAVIT-in-AFFIRMATION-of-FACTS-Notice_FORMAT.html
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<div style="text-align: justify;text-justify: inter-word;">
<h2><u><b>AFFIANT AFFIDAVIT in AFFIRMATION of FACTS</b></u></h2>
by AFFIANT <span style="background-color: #FFFF00">__AFFIANT__</span> on the date exactly of
The MONTH <span style="background-color: #FFFF00">__MONTH__</span> DAY <span style="background-color: #FFFF00">__DAY__</span> and year <span style="background-color: #FFFF00">__YEAR__</span> at the TIME EXACTLY of <span style="background-color: #FFFF00">__TIME__</span>
<br/><br/>
To YOU, the ADDRESSEE of name and physical addresses as being :<br/>
<span style="background-color: #FFFF00">__ADDRESSEE__</span>
<br/><br/>
This OFFICIAL DOCUMENT is forwarded to you via REGISTERED MAIL with TRACKING :
Registered/ Certified Mail Tracking number is : <span style="background-color: #FFFF00">__TRACKING_NUMBER__</span>
<br/><br/>
<hr />
OFFICIAL COMPOSED AFFIANT JURAT in TESTIMONIAL STATEMENT OF FACTS
<hr />
<h2><u>SUMMARY OF TESTIMONIAL FACTS</u></h2>
brought forward for consideration and lawful INSERTION:
<br/><br/>
THE AGREED STATEMENT OF FACTS is for the purpose of ADEQUATE and TRUTHFUL REQUISITE consumer reporting and record keeping , specifically in respects to the nationally recognized three major credit reporting repositories of EXPERIAN, EQUIFAX , and TRANS UNION as well as INNOVIS, LEXISNEXIS, ID ANALYTICS, ARS (Advanced Resolution Services ) , and SAGE STREAM LLC among others as well as any entity of which may be involved in any manner with consumer reporting as related to this affiant of note hereby making this exact true and lawful AAAF NOTICE (Affiant Affidavit in Affirmation of FACTS) on date displayed and notarized on by an official of the state lawfully in capacity to make such declaration.
<br/><br/>
<h2><u>BE IT KNOWN and be it ACCEPTED the following FACTS :</u></h2>
<u>AFFIANT FORWARDED FACT #1)</u><br/>
Affiant first name is and only is <span style="background-color: #FFFF00">__FIRST_NAME__</span>
<br/><br/>
<u>AFFIANT FORWARDED FACT #2)</u><br/>
Affiant Last name is and only is <span style="background-color: #FFFF00">__LAST_NAME__</span>
<br/><br/>
<u>AFFIANT FORWARDED FACT #3)</u><br/>
Affiant TRUE AND COMPLETE RESIDENTIAL and MAILING Street NUMBER is and only is <span style="background-color: #FFFF00">__STREET_NO__</span>
<br/><br/>
<u>AFFIANT FORWARDED FACT #4)</u><br/>
Affiant TRUE AND COMPLETE RESIDENTIAL and MAILING Street Name is and only is <span style="background-color: #FFFF00">__STREET_NAME__</span>
<br/><br/>
<u>AFFIANT FORWARDED FACT #5)</u><br/>
Affiant TRUE AND COMPLETE RESIDENTIAL and MAILING CITY Name is and only is <span style="background-color: #FFFF00">__CITY__</span>
<br/><br/>
<u>AFFIANT FORWARDED FACT #6)</u><br/>
Affiant TRUE AND COMPLETE RESIDENTIAL and MAILING STATE Name is and only is <span style="background-color: #FFFF00">__STATE__</span>
<br/><br/>
<u>AFFIANT FORWARDED FACT #7)</u><br/>
Affiant TRUE AND COMPLETE CURRENT SOCIAL SECURITY NUMBER is and only is <span style="background-color: #FFFF00">__CURRENT_SSN__</span>
<br/><br/>
<u>AFFIANT FORWARDED FACT #8)</u><br/>
Affiant TRUE AND COMPLETE CURRENT DATE OF BIRTH is and only is <span style="background-color: #FFFF00">__CURRENT_DOB__</span>
<br/><br/>
<u>AFFIANT FORWARDED FACT #9)</u><br/>
Affiant hereby officially REMOVES any and all authority for YOU or any entity to retain,
report, use, transfer, sell, accept,or else wise ANY NOT REQUISITE information related to
affiant , true or not. This consumer ERADICATION of your authority is effective TODAY,
even here and now.
<br/><br/>
<u>AFFIANT FORWARDED FACT #10)</u><br/>
Affiant hereby makes a lawful DEMAND in request for adequate and provable physical
document verifiable PROOF in undeniable and irrefutable validation of any and all items
of derogatory and or adversary matter for which you have, have had, or may have in
future, true or not.
<br/><br/>
<u>AFFIANT FORWARDED FACT #11)</u><br/>
Affiant announces consumer right to make composed , writ or otherwise , challenges to
any uncertainty of certificates as above requested or otherwise any and all
deficiency(ies) of testimonial certificate of absolute clarity in any and all data and or
information for which you now, have in past, r may in future possess through any means
from any source for any reason!
<br/><br/>
__START1__
<u>AFFIANT FORWARDED FACT #12)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor1__</span>
<br/> <br/>
__END1__
__START2__
<u>AFFIANT FORWARDED FACT #13)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor2__</span>
<br/> <br/>
__END2__
__START3__
<u>AFFIANT FORWARDED FACT #14)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor3__</span>
<br/> <br/>
__END3__
__START4__
<u>AFFIANT FORWARDED FACT #15)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor4__</span>
<br/> <br/>
__END4__
__START5__
<u>AFFIANT FORWARDED FACT #16)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor5__</span>
<br/> <br/>
__END5__
__START6__
<u>AFFIANT FORWARDED FACT #17)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor6__</span>
<br/> <br/>
__END6__
__START7__
<u>AFFIANT FORWARDED FACT #18)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor7__</span>
<br/> <br/>
__END7__
__START8__
<u>AFFIANT FORWARDED FACT #19)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor8__</span>
<br/> <br/>
__END8__
__START9__
<u>AFFIANT FORWARDED FACT #20)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor9__</span>
<br/> <br/>
__END9__
__START10__
<u>AFFIANT FORWARDED FACT #21)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor10__</span>
<br/> <br/>
__END10__
__START11__
<u>AFFIANT FORWARDED FACT #22)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor11__</span>
<br/> <br/>
__END11__
__START12__
<u>AFFIANT FORWARDED FACT #23)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor12__</span>
<br/> <br/>
__END12__
__START13__
<u>AFFIANT FORWARDED FACT #24)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor13__</span>
<br/> <br/>
__END13__
__START14__
<u>AFFIANT FORWARDED FACT #25)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor14__</span>
<br/> <br/>
__END14__
__START15__
<u>AFFIANT FORWARDED FACT #26)</u><br/>
<u>Affiant hereby today, even here and right now, enacts affiant right to contest your
retaining and or reporting of the following currently unfounded or unproven to be fully
true, correct, complete, timely, of affiant ownership, of affiant responsibility , and or else
wise proven compliant to any and all requisites laws and regulations, mentioned or not.
The following information is hereby demanded removed or deleted or blocked from
future retaining or reporting to any and all entities, none excluded. Please consider in
consumer complaint the following:</u><br/>
<span style="background-color: #FFFF00">__creditor15__</span>
<br/> <br/>
__END15__
__START21__
<u>AFFIANT FORWARDED FACT #27)</u><br/>
<span style="color: #FF0000;">Limit access to consumer information. A consumer reporting agency may not provide
consumer credit report to any party that lacks a permissible purpose, such as the evaluation
of an application for a loan, credit, service, or employment. Permissible purposes also
include several business and legal uses. Affiant does so today, here and now, demand in
request for any and all allegations of inquiry be certified with adequate and mandated
permissible purpose. Further, affiant does so today,here and now, challenge any and all
alleged reporters of claimed inquiries with supposed permissible purpose present undoubted
and physically verifiable document proof of said alleged permissible purpose. Affiant
demands this document proof of testimonial fact to be presented to affiant within and no later
than the federally defined lawful timely manner, generally n later than thirty days upon
notification from alleged consumer in complaint and challenge, as is being leveraged here
and now.</span><br/>
<u>Affiant calls to check and challenge of the alleged inquiry claimed by the following data
provider and on the following alleged date, please eradicate the claim or else provide
testimonial certificate of facts rebutting my complaint and requested removal in permanent:</u><br/>
<span style="background-color: #FFFF00">__limit_creditor1__</span>
<br/> <br/>
__END21__
__START22__
<u>AFFIANT FORWARDED FACT #28)</u><br/>
<span style="color: #FF0000;">Limit access to consumer information. A consumer reporting agency may not provide
consumer credit report to any party that lacks a permissible purpose, such as the evaluation
of an application for a loan, credit, service, or employment. Permissible purposes also
include several business and legal uses. Affiant does so today, here and now, demand in
request for any and all allegations of inquiry be certified with adequate and mandated
permissible purpose. Further, affiant does so today,here and now, challenge any and all
alleged reporters of claimed inquiries with supposed permissible purpose present undoubted
and physically verifiable document proof of said alleged permissible purpose. Affiant
demands this document proof of testimonial fact to be presented to affiant within and no later
than the federally defined lawful timely manner, generally n later than thirty days upon
notification from alleged consumer in complaint and challenge, as is being leveraged here
and now.</span><br/>
<u>Affiant calls to check and challenge of the alleged inquiry claimed by the following data
provider and on the following alleged date, please eradicate the claim or else provide
testimonial certificate of facts rebutting my complaint and requested removal in permanent:</u><br/>
<span style="background-color: #FFFF00">__limit_creditor2__</span>
<br/> <br/>
__END22__
__START23__
<u>AFFIANT FORWARDED FACT #29)</u><br/>
<span style="color: #FF0000;">Limit access to consumer information. A consumer reporting agency may not provide
consumer credit report to any party that lacks a permissible purpose, such as the evaluation
of an application for a loan, credit, service, or employment. Permissible purposes also
include several business and legal uses. Affiant does so today, here and now, demand in
request for any and all allegations of inquiry be certified with adequate and mandated
permissible purpose. Further, affiant does so today,here and now, challenge any and all
alleged reporters of claimed inquiries with supposed permissible purpose present undoubted
and physically verifiable document proof of said alleged permissible purpose. Affiant
demands this document proof of testimonial fact to be presented to affiant within and no later
than the federally defined lawful timely manner, generally n later than thirty days upon
notification from alleged consumer in complaint and challenge, as is being leveraged here
and now.</span><br/>
<u>Affiant calls to check and challenge of the alleged inquiry claimed by the following data
provider and on the following alleged date, please eradicate the claim or else provide
testimonial certificate of facts rebutting my complaint and requested removal in permanent:</u><br/>
<span style="background-color: #FFFF00">__limit_creditor3__</span>
<br/> <br/>
__END23__
__START24__
<u>AFFIANT FORWARDED FACT #30)</u><br/>
<span style="color: #FF0000;">Limit access to consumer information. A consumer reporting agency may not provide
consumer credit report to any party that lacks a permissible purpose, such as the evaluation
of an application for a loan, credit, service, or employment. Permissible purposes also
include several business and legal uses. Affiant does so today, here and now, demand in
request for any and all allegations of inquiry be certified with adequate and mandated
permissible purpose. Further, affiant does so today,here and now, challenge any and all
alleged reporters of claimed inquiries with supposed permissible purpose present undoubted
and physically verifiable document proof of said alleged permissible purpose. Affiant
demands this document proof of testimonial fact to be presented to affiant within and no later
than the federally defined lawful timely manner, generally n later than thirty days upon
notification from alleged consumer in complaint and challenge, as is being leveraged here
and now.</span><br/>
<u>Affiant calls to check and challenge of the alleged inquiry claimed by the following data
provider and on the following alleged date, please eradicate the claim or else provide
testimonial certificate of facts rebutting my complaint and requested removal in permanent:</u><br/>
<span style="background-color: #FFFF00">__limit_creditor4__</span>
<br/> <br/>
__END24__
<span style="font-size:20px;"><u>Correct or delete inaccurate information.</u></span> A consumer reporting agency must correct or, as the case may be, delete from any consumer’s credit file the information that isfound to be inaccurate or can no longer be verified as entirely fully current, true, correct, complete, timely, of consumer’s ownership, of consumer’s responsibility, absolute and
irrefutably compliant to any and all reporting laws and regulations, proven by testimonial document certificate of that compliance alleged, or elsewise as requisite of reporting, be it mentioned or not by the consumer.
<br/> <br/>
<span style="font-size:20px;"><u>Investigate disputed information.</u></span> If consumer tell a consumer reporting agency that your file contains inaccurate information, the agency must promptly investigate the matter with the source that provided the information.
<br/> <br/>
<span style="font-size:20px;"><u>Consumers may seek damages from violators.</u></span> If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, consumers may be able to sue in state or federal court.
<br/> <br/>
<span style="font-size:20px;"><u>States may enforce the FCRA,</u></span> and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. Affiant does as now today, here and now, demand in request that the receiver of this AAAF NOTICE ensure that all affiant state laws are abided without fail, any deficiencies will result in affiant seeking of favorable resolution in a civil court of affiant selection. Federal and state laws are NOT ignorable by any entity , whether willfully or in ignorance.
<br/> <br/>
<span style="font-size:20px;"><u>e-OSCAR is a web-based, Metro 2 compliant, automated system</u></span> that enables Data Furnishers (DFs), and Credit Reporting Agencies (CRAs) to create and respond to consumer credit history disputes. ANY AND ALL ENTITIES of reporting must be reporting certifiably in adequate and complete correct Metro 2 format reporting, absolute and perfect Metro 2 format is mandated and is not optional. I request in demand any and all certificates of proof of such alleged compliant reportingand further the CERTIFICATION of the reporters of their certified Metro 2 format training, or else eradicate any and all allegations of adversary and or derogatory nature, contested by affiant or not, mentioned or not, true or not. COMPLIANCE is MANDATED, demonstrate such in absolute clarity!
<br/> <br/>
Please make notice to this declaration being that one and in of the same as an Affiant acknowledgement of AFFIANT INTENTION of future civil suit for favorable affiant resolution should addressee of this AAAF NOTICE (Affiant Affidavit in Affirmation of Facts Notice) be of derelict collection and or reporting of not proven compliant allegations of injurious adversary and or derogatory claims, particularly any and all items of which affiant has here in this statement made notice to in composition. I demand in request that receiver of this declaration accept it as being officially my CONSUMER DECLARATION to ANNUL ALLEGED DATA not requisite reported or else wise not as required CERTIFIED in it’s entirety as being fully current, true, correct, complete, timely, of affiant’s ownership, of affiant’s responsibility, certifiably compliant to all collection and or reporting laws, and or with proven testimonial and documented certificate of said compliant as is mandated by law.Affiant today, here and now, foreverly demands receiver to CEASE activity(ies) of adversary or derogatory nature versus affiant , even those of collection and or reporting, or else any action even if not here mentioned!
<br/> <br/>
<br/> <br/>
TODAY IS __TODAY__
<br/>
<br/>
FROM ME===MY FIRST AND LAST NAME, STREET NUMBER AND STREET NAME, CITY
AND STATE IS AND ONLY IS:
<br/>
<span style="background-color: #FFFF00"> __FIRST_NAME__ __LAST_NAME__, __STREET_NO__, __STREET_NAME__, __CITY__, __STATE__. </span>
<br/> <br/>
This here document declaration to include the following notarized section(s) shall serve as unmistaken lawful AFFIANT AFFIDAVIT in AFFIRMATION of FACTS by me, the affiant. This document declaration in its entirety is issued to you as being a provable affidavit that is a sworn voluntary, sworn written statement, sworn desired.
<br/>
My name is that same as of the noted of the affiant, I am the person giving the statement, I am as well mentioned in the affidavit and as the true affiant understand now and in future of fact I am and was required to sign the affidavit in the notary’s presence, as is done.
<br/> <br/>
State of _________________________________<br/>
County of _________________________________ )<br/>
Before me, the undersigned notary public, this day, personally, appeared _________________________________ to me known, who being duly sworn according to law, deposes the following:
<br/><br/>
I demand eradication of alleged claims, be them or not be them debts, to be satisfied and settled in full or else wise annulled without prejudice and or injury to me the consumer alleged of unproven debt and or adversary and or derogatory claims. I demand absolute proof proof of any debts alleged, account history alleged, ownership alleged, responsibility alleged, truth as reported, accuracy as reported, completeness as reported, timeliness as reported, and full compliance as reported o otherwise attempted in collection. Deficient of requested document testimony in composed writ form, you must cease reporting and equivalently reporting of this unfounded claim of derogatory debt. Thank you in full!
<br/><br/>
_________________________________ (Signature of Affiant)<br/><br/>
Subscribed and sworn to before me this ____________ day of ______________ , 20_______ .<br/>
_____________________________________________________________________________________<br/>
Notary Public<br/>
My Commission Expires: _________________________________
<br/><br/><br/>
__STARTM1__
Evidence of my Proof of identification<br/><br/>
<img src="__image1__" alt="Evidence of my Proof of identification">
<br/><br/><br/>
__ENDM1__
__STARTM2__
Proof of residence or mailing address<br/><br/>
<img src="__image2__" alt="Proof of residence or mailing address">
<br/><br/><br/>
__ENDM2__
__STARTM3__
Proof of social security number<br/><br/>
<img src="__image3__" alt="Proof of social security number">
<br/><br/><br/>
__ENDM3__
__STARTM4__
My Notarized Letter/Form<br/><br/>
<img src="__image4__" alt="Your Notarized Letter/Form">
<br/><br/><br/>
__ENDM4__
__STARTM5__
My Notarized Letter/Form<br/><br/>
<img src="__image5__" alt="Your Notarized Letter/Form">
<br/><br/><br/>
__ENDM5__
</div>
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