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Certified mail no: ___________________________________

NOTICE TO CHANGE STATUS FROM DECEDENT TO NON-DECEDENT

To: IRS

From: Mark-Lester: Metz


C/o 1234 Osha Street
Palm Beach Gardens, Florida
[33444]

Dear Officer:

Here are the documents that you require as proof that I am a Non-Decedent.
IRS manual 21.7.13.3.2.2 - An infant is the decedent of an estate or grantor, owner or trustor of a trust, guardianship,
receivership or custodianship that has yet to receive an SSN.

Please update my MASTER FILE to indicate Non-Decedent.

Documents enclosed three (3)


1. Certificate of Live Birth
2. Social Security Card
3. United States Passport

I, Mark-Lester: Metz (a living man) under my unlimited liability and Oath proceeding in good faith being of
sound mind states that the facts contained herein are true, correct, complete and not misleading to the best of
Mark-Lester: Metz (a living man) knowledge and belief under penalty of Law. 

 
Certified mail no: ___________________________________

 
Florida Republic ) 
                                                       ) scilicet 
County of Palm Beach ) 

BY: __________________________________ 
Mark-Lester: Metz,
All Rights Reserved None Waved,
Without Prejudice UCC 3-402 (b)(1), 
Authorized Representative and living man

ACKNOWLEDGEMENT 
 

In witness hereof, I hereunto set my hand and official seal. The above-named living man, personally
known to me, appeared before me a Notary, Sworn and under Oath this____ day of
______________________ 2020. 

____________________________________
Notary

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