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Certified Return Mail Number _________________________________

Name and Address


…………………………….
…………………………….
……………….

ANY AGENCY OF STATE OR DEPT.


…………………………….
…………………………….
……………….

November 8, 2007

RE: CONDITIONAL ACCEPTANCE – REQUEST FOR PROOF OF CLAIM


Reference Citation(Account) No. 00000000000 & Case No. 000000

Dear Mr. ‘Officer’ and/or ‘Prosecutor’:

In regards to the above ‘Styled Case,’ as I want resolve this matter as soon as possible, I
find necessary to exhaust the my administrative remedy as to your presentment and offer(s) of
your commercial instruments of which I accept for value and agree to ‘pay at law’ the fine
and even go to jail in behalf of the Debtor that you have brought the claim/charges against,
but I can only do so conditioned upon you providing ‘Proof(s) of Claim,’ relative to
Jurisdiction, authority, Oath of Office, Bond, misapplication of statute, or otherwise and as
such, the necessary Proof(s) of Claim are enumerated below:

1. PROOF OF CLAIM on how the Nevada Constitution operates upon me, a private man.

2. PROOF OF CLAIM that the Prosecutor and the officers of the court are
bound to support Amendment in Article I, § X, (No State shall… make any Thing but
gold and silver coin a Tender in Payment of Debts).

3. PROOF OF CLAIM that the officers and employees of the Department of Revenue are
bound to support Article XI, § I (of the Oregon Constitution) “…nor shall any bank…
putting into circulation any bill, check, certificate, or other paper (NOTE(S)), or the paper
of any bank company (‘federal reserve’ NOTE(S) ,… to circulate as money.” (this point
operates in every other state thru the Para Materia Rule.)

3. PROOF OF CLAIM that, in relation to any monetary penalty, the “giving a (federal
Reserve) note does constitute payment.” See Echart v Commissioners C.C.A., 42 Fd2d
158.

4. PROOF OF CLAIM that, in relation to any monetary penalty the use of a (federal
reserve) ‘Note’ is not only a promise to pay. See Fidelty Savings v Grimes, 131 P2d 894.

1 – CAFV for Traffic Citation Item # 112707-1/TC


4. PROOF OF CLAIM that Legal Tender (federal reserve) Notes are good and lawful
money of the United States, in relation to any monetary penalty. See Rains v State, 226
S.W. 189.

5. PROOF OF CLAIM that (federal reserve) ‘Notes do operate as payment in the absence
of an agreement that they shall constitute payment.’ See Blachshear Mfg. Co. v Harrell,
12 S.E. 2d 766.

6. PROOF OF CLAIM that the secured party has access to ‘lawful money of account’ to
‘pay’ debts at law without becoming a tort feasor.

7. PROOF OF CLAIM that you as the citing officer in this matter took an Oath of Office to
support, defend, and uphold in any capacity the State Constitution and the United States
Constitution as a requirement of your position/office and that you will provide a certified
copy to the Undersigned.

8. PROOF OF CLAIM that you as the citing officer in this matter that you took out or
possess a Performance Bond as a requirement of your position/office to indemnify the
Undersigned in the event you cause harm or injury to his person, property or rights and
that you will provide a certified copy to the Undersigned.

9. PROOF OF CLAIM that you as the citing officer bringing forth this claim can testify on
the witness-stand and/or thru providing Proof(s) of Claim of the same and/or bring all
relevant evidence/Proof of Claim including but not limited to constitutional
impermissible application of the statute in this matter as it applies to the Undersigned.

CAVEAT

Please understand that I want to resolve this matter as soon as possible, I realize that I may
have made a few mistakes in the past, but understanding my Right to exhaust my
administrative remedy/process in this commercial matter, I now request the above ‘Proof(s) of
Claim’ that you are rely upon to support your claim(s) in this matter.

Per your failure or refusal to bring forth ‘Proof(s) of Claim,’ you will be found in default
and dishonor and will have stipulated, agreed and confessed to and failed to state a claim upon
which relief can be granted, you will have admitted a damage and injury to this private man
and you will have stipulated to all the facts that operate in favor of the Undersigned; that this
private man herein is not subject to the Oregon Vehicle Code, That you lacked jurisdiction
and authority to cite the Undersigned, that you misapplied the statute, or otherwise to commit
fraud and cause injury to the Undersigned.

You also agree that the Undersigned has a right to travel in his private conveyance in non-
commercial use of same as you agree the Undersigned is not bound to the Motor Vehicle code
or statute and as to any monetary fine via your tendered citation/instrument(s), that the
Undersigned can accept for value and return for discharge pursuant to the remedy provided by

2 – CAFV for Traffic Citation Item # 112707-1/TC


Congress via HJR-192 to allow the discharge the debt (monetary penalty-demand for
payment) in behalf of the person/Debtor named on the charging instrument or by and through
any appropriate commercial paper.

You are required to send the ‘Proof(s) of Claim both to the Undersigned and to the Third
party or Notary as address below.

The Undersigned private man herein respectfully requires you as the citing Officer to reply
within Ten (10) days, due to the time frame allotted to these types of commercial transactions.

A non-response and or failure to provide the requested ‘Proof(s) of Claim’ will constitute
agreement by you that you bind your employer (city, county or state) for damages via fraud
and misapplication of statute and otherwise stated above via law suit or Tort Claim under
necessity in violation if any upon your Oath of Office.

Thanking you in advance in this matter, I remain

Sincerely

Without Prejudice

____________________________________________
……………………….., Secured Party Creditor,
Authorized Representative, Attorney-In-Fact in behalf
of DEBTORS NAME©, Ens legis

Third party or Notary’s address:

……………………………….
…….…………………………
……………………………….
……………….

3 – CAFV for Traffic Citation Item # 112707-1/TC

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