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Friday 26 October 2012

NOUICOR FEE SCHEDULE COVERING LETTER


Date: [INSERT DATE]

WITHOUT PREJUDICE
To whom it may concern.

Dear Sir or Madam

I hope this letter and the accompanying notice finds you well and leaves you better. You will find attached one Notice of Understanding and Intent and Claim of Right which contains seven pages, in addition to this cover letter, which contains two pages, (this and one other). I have crafted this Notice of Understanding and Intent and Claim of Right for the purpose of avoiding future conflicts when I begin exercising the rights claimed therein. It is my desire and intent to live freely, peacefully, and within community standards, and do so in an orderly and honourable manor, but without license, permission, restrictions or governance from your organisations. I am not “anti-government” nor do I advocate lawless behaviour, much to the contrary I wish to prove through my actions that good, orderly, reasonable behaviour need not be mandated to exist. I think government has its place in remedying conflict, and regulating those who wish to operate in limited liability. I wish to operate in full liability and without government interference. I do not wish to be a “thorn in your side” and I intend to fulfil my duties to protect the freedom of speech by improving the Internet and to use innovation, and creativity to make [INSERT TOWN NAME WHERE YOU LIVE], The United Kingdom, and the world at large a nicer place to live; needless to say if you are not bothering me I will have no time to bother you.

If you are bureaucratic in nature, these ideas may come as a bit of a surprise, but I think that with some observation, you will find that all of the creative energy that shapes our world comes from people who choose to act differently from their neighbours, and everyone who hasn't read all of the “bodies-of-words” that may have authority over them, lives in fear of being tried for violating something which they don't understand, and only does things that have already been done and proven “safe” with the government. Thus, the creativity of the people, and the productivity of a country, can be subverted by its government holding the people accountable for too much “law”.

Before literacy was widespread, law was written down, but the few who could read could interpret it however they pleased, or even make it up when telling the law to the illiterate. Literacy is a prized skill here because we understand that without being able to read we are at the mercy of those who can. Neither I, nor anyone I know, nor even anyone I have heard about, has read every word in the law library. Are we returning to an age when the majority is subjugated by the minority who understands the law?

Regardless of the overall trends, I have made a good-faith effort to read, and understand every law that may pertain to me, and have found this task to be beyond my abilities. I could not even find a map of which law applies to whom. I found deceptive language in the form of words, which looked like they meant one thing in context but, upon looking them up in a law dictionary, I found they actually mean something completely different. I found numerous references such as “has as much authority as a” which requires anyone who wants to understand the law to constantly need to ask more questions, amounting to “rabbit trails” of paperwork to follow in order to gain any meaningful insight. I found the words in the law library to be vague and very easy to construe in many different ways. I have a sound understanding of computers, and software, and it is my understanding that if the papers in the law library were software to run a programme, when taken as a whole, it would cause the system to crash. If somebody purposely wrote vague statutes in order that they would have multiple meanings, one or more of which would lead a reasonable person to violate the de facto Constitution the United Kingdom if acting as a public servant, then somebody has committed fraud.

Whether or not fraud was committed, I cannot read, understand, nor in good faith try to follow, all of the statutes, regulations, orders, and other words that have been written without my consent.

The remedy I have found is to make known to the world my understanding and intent, and claim the rights, which I believe to be mine. Any who disagree have an opportunity to discuss and negotiate, but those who silently wait out their opportunity and then take legal action once I begin exercising my rights are acting like predators, lying in wait and maximising conflict - and they are dishonouring my notice and dishonouring a main pillar of the Rule of Law, which clearly states that “conflict is avoidable and undesirable”.

I hope this letter causes you to think deeply and I hope you understand that your authority depends on the moral high ground, for your own credibility, and that of your government as a whole.

Your legal-system was designed to destroy the lives of those who make their living doing injury upon others, and rightly so, but if you seek out peaceful claimers of rights, and persecute them, you will create a political movement, and freedom should only be for those mature enough to accept responsibilities. However, by agreeing to coexist peacefully, you may preserve your authority, and colour of authority for a long time to come.

In closing, I bid you fare-thee-well and wish you all the best in your endeavours. Without ill will, malice aforethought, frivolity or vexation, but with the intent of avoiding future conflicts or disputes by stating clearly my understanding and intentions, and by claiming my rights before exercising them.

I hereby sign this document with the "symbol" I have adopted below, to seal my present intention to authenticate this document.

Signed and dated on this, the [DATE] day of May in the year of our Lord 2009.

Sign your name here in RED INK
_______________________________________________
Freeman-on-the-land [FIRST NAME] of the family of [FAMILY NAME]

P.S. If you are unfamiliar with the term “A Freeman-on-the-land” it is a flesh and blood man and one of the people, who operates with full responsibility,  and has not given, or has lawfully revoked, consent to be represented or governed and, in any common law jurisdiction, a Freeman-on-the-land exists free of any statutory restrictions, obligations, and limitations...

NOTICE OF UNDERSTANDING AND INTENT AND CLAIM OF RIGHT [INCLUDING FEE SCHEDULE]


Notice of Understanding and Intent and Claim of Right
[Including FEE SCHEDULE]

Whereas it is my understanding...
I, [FIRST NAME: FAMILY NAME], Sui Juris, a flesh and blood man and blessed living Soul serving God alone, do hereby state the following is My Statement of Truth:
Whereas it is my understanding that the United Kingdom is a common law jurisdiction, and,
Whereas it is my understanding that equality before the law is paramount and mandatory, and,
Whereas it is my understanding that a statute is defined as legislated rule of a society which has been given the force of law, and,
Whereas it is my understanding that a society is defined as a number of people joined by mutual consent to deliberate, determine, and act for a common goal, and ,
Whereas it is my understanding that the only form of government recognised as lawful in the United Kingdom of Great Britain and Ireland is a representative one, and,
Whereas it is my understanding that representation requires mutual consent, and,
Whereas it is my understanding that in the absence of mutual consent neither representation nor governance can exist, and,
Whereas it is my understanding that all Acts are statutes restricted in scope and applicability by the Constitution and/or Bill of Rights, and,
Whereas it is my understanding that said scope and applicability is limited to members and employees of government, and,
Whereas it is my understanding that those who have an NI number (National Insurance Number) are in fact employees of the UK government and thus are bound by the statutes created by the UK government, and,
Whereas it is my understanding that it is lawful to abandon one’s NI number, and,
Whereas it is my understanding that human beings in the United Kingdom of Great Britain and Ireland have a right to revoke or deny consent to be represented and thus governed, and,
Whereas it is my understanding that if anyone does revoke or deny consent they exist free of government control and statutory restraints, and,
Whereas a Freeman-on-the-Land has lawfully revoked consent and does exist free of statutory restrictions, obligations, and limitations, and,
Whereas I, [FIRST NAME: FAMILY NAME] am a Freeman-on-the-Land, and,
Whereas it is my understanding that acting peacefully within community standards does not breach the peace, and,
Whereas it is my understanding that any action for which one can apply for and receive a license must itself be a fundamentally, lawful action, and,
Whereas I am not a child, and,
Whereas I am a peaceful human being, and,
Whereas I am a Freeman-on-the-Land who operates with full responsibility, I do not see the need to ask permission to engage in lawful and peaceful activities, especially from those that claim limited liability, and,
Whereas it is my understanding that a by-law is defined as a rule of a corporation, and,
Whereas it is my understanding that corporations are  legal fictions and require contracts in order to claim authority or control over other parties, and,
Whereas it is my understanding that legal fictions lack a soul and cannot exert any control over those who are thus blessed and operate with respect to that knowledge as only a fool would allow soulless fictions to dictate to ones actions, and,
Whereas it is my understanding that I have a right to use my property without having to pay for the use or enjoyment of it, and,

Whereas it is my understanding that natural law is the permanent underlying basis of all law, and theories of natural law have been an important part of jurisprudence throughout legal history. Natural law is distinguished from positive law, which is the body of law imposed by the state. Natural law is both anterior and superior to positive law. Oxford Dictionary Of Law 5th Edition ISBN0-19-860756-3 page 326.
Whereas it is my understanding that Common Law which applies to all living souls is: We are free to do what we please, as long as we do not infringe on the life, liberty, property, or rights of another.
Whereas it is my understanding the United Kingdom is a common law jurisdiction, and,
Whereas it is my understanding that Parliament which has no lawful authority ever to breach, surrender, lend or transfer (even temporarily) sovereignty except when conquered in war, and,

Whereas I do firmly and truly believe the signing of European Union Lisbon Treaty is an overt act of treason, and,
Whereas it is my understanding that no one (neither Monarch, nor Prime Minister, nor any prelate, politician, judge or public servant) is above the Common Law of the United Kingdom that forms the British Constitution (including Magna Carta [1215], the Declaration and Bill of Rights [1688/89], Acts of Union, Succession and Settlement [1701-07], the Coronation Oath Act [1689]).
Whereas it is my understanding equality before the law is paramount and mandatory, and,
Whereas it is my understanding a statute is defined as a legislated rule of society which has been given the force of law, and,
Whereas it is my understanding a society is defined as a number of people joined by mutual consent to deliberate, determine and act for a common goal, and,
Whereas it is my understanding that for something to exist legally it must have a name, and,
Whereas it is my understanding the only form of government recognised as lawful in the United Kingdom is a representative one, and,
Whereas it is my understanding representation requires mutual consent, and,
Whereas it is my understanding that in the absence of mutual consent neither representation nor governance can exist, and,
Whereas it is my understanding people in the United Kingdom have a right to revoke or deny consent to be represented and thus governed, and,
Whereas it is my understanding if anyone does revoke or deny consent they exist free of government control and statutory restraints, and,
Whereas it is my understanding that a claim of right establishes a lawful excuse and that this factual truth is expressed by way of example in the Theft Act 1968 and the Criminal Damage Act 1971, where belief must be that the law creates and vests a specific right to act in that way. In English law, a limited form of statutory offence is termed "claim of right". In Chamberlain v Lindon [1998] 1 WLR 1252 [1] Lindon demolished a wall to protect a right-of-way, Despite allowing nine months to pass before acting, Lindon honestly believed that it was immediately necessary to protect his legal rights without having to resort to civil litigation. For the purposes of s5(2): it is not necessary to decide whether Lindon’s action was justified as a matter of civil law. For the purpose of the criminal law, what matters is whether Lindon believed that his actions were reasonable, i.e. a subjective test.
Thus a "lawful excuse" may be acknowledged by a court to arise when a person honestly, even if mistakenly, believes that the actions are necessary and reasonable, and,
Whereas it is my understanding that if one has lawful excuse one may choose to not obey a court, tribunal, statute, Act or order, and that this factual truth is expressed by way of example in the Theft Act 1968 and the Criminal Damage Act 1971 and,
Whereas it is my understanding that government does not clearly express that one may be charged for failure to obey a de facto government or court, and,
Whereas it is my understanding that all existing courts and governments are de facto only and not de jure, and,
Whereas it is my understanding that agreements made on behalf of the United Kingdom by traitors to the United Kingdom do not bind the people of the United Kingdom, and,
Whereas I honourably refuse to be bound by agreements made by traitors, and,
Whereas it is my understanding that any police officer who co-operates with foreign armed troops to govern or regulate the population is also committing treason, and,
Whereas it is my understanding that historically the purpose of a national armed force was to ensure that foreign powers never invaded and governed under a force of arms, and,
Whereas it is my understanding that the existence of armed foreign troops patrolling and policing our streets is evidence of a war fought unsuccessfully, and,
Whereas it is my understanding that agreeing or conspiring to agree to allow armed foreign troops to patrol and police our streets is an act of treason, and,
Whereas a flesh and blood man and blessed living Soul serving God alone, has lawfully revoked consent and does exist free of statutory restrictions, obligations, and limitations, and,
Whereas I, [FIRST NAME: FAMILY NAME], am a flesh and blood man and blessed living Soul serving God alone, and,
Whereas it is my understanding that acting peacefully within community standards does not breach the peace, and,
Whereas it is my understanding that any action for which one can apply for and receive a license must itself be a fundamentally lawful action, and,
Whereas as I, not a child, am a flesh and blood man and blessed living Soul serving God alone, who operates with full responsibility and I do not see the need to ask permission to engage in lawful and peaceful activities, especially from those who claim limited liability, and,
Whereas it is my understanding a bye-law is defined as a rule of a corporation or corporate body, and,
Whereas it is my understanding corporations are legal fictions and require contracts in order to claim authority or control over other parties, and,
Whereas it is my understanding legal fictions lack a soul and cannot exert any control over those who are thus blessed and operate with respect to that knowledge as only a fool would allow soulless fictions to dictate ones actions, and,
Whereas it is my understanding that I can use a public notary, or any authorised officer of a court, to perform duties found under any act thus they have the power to hold court and hear evidence and issue binding lawful judgements, and,
Whereas it is my understanding that a public notary, or any authorised officer of a court, can also be used to bring criminal charges to bear against traitors, even if they hold the highest office, and,
Whereas it is my understanding that I have a right to use my property without having to pay for the use or enjoyment of it, and,
Whereas I claim the right to claim, collect, receive or be paid any pension if I have paid into it, or am otherwise entitled to, and claim that said right is not affected by anything I do, if I abandon my National Insurance Number  and,
Whereas it is my understanding that a summons is merely an invitation to attend and the ones issued by any court creates no obligation or dishonour if ignored, and,
Whereas it is my understanding police officers or peace officers who attempt to enforce statutes against Freeman-on-the-Land, a flesh and blood man and blessed living Soul serving God alone, are in fact breaking the law, and,
Whereas it is my understanding that I have the power to refuse intercourse or interaction with police officers or peace officers who have not observed me breach the peace, and,
Whereas it is my understanding that permanent estoppel by acquiescence barring any police officer or prosecutor from bringing charges against a Freeman-on–the Land, flesh and blood man and blessed living Soul serving God alone, under any Act is created if this claim is not responded to in the stated fashion and time, and,
Whereas it is my understanding that the common law right to travel on the highways without license provided we are not engaging in commerce thereupon is lawful and still exists although it does appear to have been deceptively hidden, and,
Whereas it is my understanding that if the police are not providing a service they have no reason to stop any one, and if proof of insurance and license is not valuable they have no need to ask for it, and,
Whereas it is my understanding that I have the right to refuse to interact or co-operate with criminals, de facto government agents or grossly negligent police officers, and,
Whereas it is my understanding that if I have the power to appoint directly or by proxy I must have the power to fulfill those duties myself, and,
Whereas it is my understanding that the Police although having an illustrious history has had members recently acting in a grossly criminal manner which does tarnish the previous history and record, and,
Whereas it is my understanding that the Law provides remedy at all times, even against rogue or negligent police officers and de facto governments apparently hijacked by soulless corporate interests, and,
Whereas it is my understanding that the act of registering the birth of a baby creates a legal entity called a “person” that exists in association with that baby and that the manner in which offspring are registered transfers superior guardianship rights over that offspring to the government, and,
Whereas it is my understanding that this creation of a person and transfer of authority is not fully disclosed to the parents and, if it was, all good parents would refuse to register their offspring, and,
Whereas it is my understanding that the person and the human being to which it is associated are two very separate and different things and that the people playing roles in government only have the right to act upon the person, and,
Whereas it is my understanding that if I do not exist in association with a person I cannot be lawfully governed by the people playing roles in government, and,
Whereas it is my understanding that I  [FIRST NAME: FAMILY NAME] have since birth registration been used as surety for the legal fiction “NAME AS SHOWN ON BIRTH CERTIFICATE (IN CAPS)”.
Whereas it is my understanding that I can, and do now, take charge of my legal fiction “NAME AS SHOWN ON BIRTH CERTIFICATE (IN CAPS)” and I  [FIRST NAME: FAMILY NAME] now act as the legal fiction “NAME AS SHOWN ON BIRTH CERTIFICATE (IN CAPS)” 3rd party agent, and,
Whereas it is my understanding that I am not obliged to obey the orders of any one
claiming to be acting on behalf of Queen or King, as no one who does make claims that abandon and erode the concept of equality has any authority over me, and,
Whereas it is my understanding that the Bible warns all players and actors of de facto courts “judge not lest you be judged”, and it is my understanding that the people in the government are merely playing roles.
Whereas it is my understanding that clause 39 “No freeman shall be arrested or imprisoned or disseised or outlawed or exiled or in any way victimised, neither will we attack him or send anyone to attack him, except by the lawful judgement of his peers or by the law of the land”, and clause 40 “To no-one will we refuse or delay right or justice”, of the original Magna Carta 1215 laws are still in effect, and that the expression “law of the land” shall mean Common Law.
Therefore be it now known to any and all interested, concerned or affected parties, that I, [FIRST NAME: FAMILY NAME] am a freeman and do hereby serve notice and state clearly, specifically, and unequivocally, my intent to peacefully and lawfully exist free of all statutory obligations, restrictions ,and that I maintain all rights at law to trade, exchange or barter and exist without deceptive governance and to do so without limitations, restrictions or regulations created by others and without my consent.
Furthermore, I claim that these actions are not outside my communities’ standards and will in fact support said community in our desire for truth and maximum freedom.
Furthermore, I claim the right to engage in these actions and further claim that all property held by me is held under a claim of right.
Furthermore, I claim the right to lawfully:
(1)    Exercise my “common law right to travel”, unhindered, unencumbered, at my discretion in my private conveyance of the day, to wit, my private, unregistered, unlicensed automobile.
(2)    Exercise my God given right to travel as stated in the Queen’s bible.
I claim that pursuant to any action by any government and/or any principal, member, employee, agent, servant, person thereof, in Right of Great Britain, a province, a municipality:
Furthermore, I claim the right to use the force that I deem appropriate to protect my property, thus preventing any other person claiming the right to use force or violence in regard to my property.
Furthermore, I claim the right to use the force that I deem appropriate to protect my physical body in all circumstances, thus preventing any other person claiming the right to use force or violence in regard to my physical body.
Furthermore, I claim the right to refuse to supply an intimate or non-intimate sample of DNA and Fingerprints for any purpose, without my written and notarised consent.
Furthermore, I claim that the courts in the United Kingdom are de-facto and bound by the Law and I further claim they require the consent of both parties prior to providing any such services.
Furthermore, I claim that anyone who interferes with my lawful activities after having been served notice of this claim, and who fails to properly dispute or make lawful counterclaim, cannot claim good faith or colour of right and that such transgressions will be dealt with in a properly convened court in full public view.
Furthermore, I claim all transactions of security interests require the consent of both parties.
Furthermore, I claim my FEE SCHEDULE for any transgressions by police officers, government principals or agents or justice system participants is:
FIVE HUNDRED BRITISH POUNDS STERLING PER HOUR, or portion thereof, if being questioned, interrogated or in any way detained, harassed or otherwise regulated and,

TWO THOUSAND BRITISH POUNDS STERLING PER HOUR or portion thereof if I am handcuffed, transported, incarcerated, regulated or subjected to any adjudication process without my express written and notarised consent.
Furthermore, I claim the right to respond with any order made by a court over or against my person against my wishes and without my express written and notarised consent will generate a bill that will be submitted to the court for immediate payment.
Furthermore, I claim the right to use a declaratory judgement, or statutory declaration or warrant, to secure payment of the aforementioned FEE SCHEDULE OR BILL FOR ORDER ISSUED IN COURT against any transgressors who by their actions or omissions harm me or my interests, directly or by proxy in any way.
Furthermore, I claim the right to convene a proper court de jure in order to address any potentially criminal actions of any police officers, government officials, principals or agents or justice system participants who, having been served notice of this claim fail to dispute or discuss or make lawful counterclaim and then interfere by act or omission with the lawful exercise of properly claimed and established rights and freedoms.
Furthermore, I claim the law of agent and principal applies and that service upon one is service upon both.
Furthermore, I claim the right to deal with any counterclaims or disputes publicly and in an open forum using discussion and negotiation and to capture on video tape said discussion and negotiation for whatever lawful purpose as I see fit. Affected parties wishing to dispute the claims made herein, or make their own counterclaims, must respond appropriately within TEN (10) days of service of notice of this action. Any, and all, Responses must be under Oath or attestation, upon full commercial liability and penalty of perjury, and received via registered mail at the address herein provided, no later than TEN (10) days from the date of original service as dated by way of Royal Mail recorded delivery service.
Failure to register a dispute against the claims made herein will result in an automatic default judgement and permanent and irrevocable estoppel by acquiescence barring the bringing of charges under any statute, act or regulation against myself, Freeman-on-the-Land  [FIRST NAME: FAMILY NAME], for exercising these lawful and properly established rights, freedoms and duties.

God Bless You.
Place of Claim of Right: [YOUR FULL ADDRESS]
United Kingdom of Great Britain and Northern Ireland
I hereby sign this document with the "symbol" I have adopted below, to seal my present intention to authenticate this document.
Signed and dated on this, the [DATE] day of May in the year of our Lord 2009.

Sign your name here in RED INK
_______________________________________________
Freeman-on-the-land [FIRST NAME] of the family of [FAMILY NAME]

QUEENS AFFIDAVIT 2 TEMPLATE


Second Affidavit of Janet: of the Family Osborne

WHEREAS It Is Now Made Plain To Me that Elizabeth the Queen has been entirely deposed from her Freedoms; Crown; Authority & Dignity, by the devious machinations of traitors and by all of those evil persons who have formerly or do now support the enterprises of treason, contrary to the Laws of God and contrary to the known laws and customs of the kingdom and people of England -
AND WHEREAS the said Elizabeth the Queen is now entirely deposed from her lawful power and authority to Govern the Nations & Peoples of the United Kingdom, with Northern Ireland –
AND WHEREAS the said Elizabeth the Queen has been and is now unlawfully restrained from providing a full and adequate response to the content and requirements of an affidavit that I have served upon her in a lawful manner –
NOW I, Janet: of the Family Osborne, now resident at  7 The Croft, Cocking, Midhurst, W. Sussex, GU29 0HQ

MAKE OATH AND SAY AS FOLLOWS –
FOR THE REASONS GIVEN within the content of the preamble to this present document, I Must and Do Now Remove Myself from All and Any Allegiance to Elizabeth the Queen, to the purpose of removing myself at law from the authority of all of those Hateful & Evil Persons who have taken it upon themselves to hold Elizabeth the Queen a prisoner in her own land – and or who have taken it upon themselves to misgovern the United Kingdom in the Queen’s Name, by the process of laying an unlawful claim to the True Authority of Elizabeth the Queen; such claim to the Royal Authority being entirely contrary to the known and most ancient laws and customs of the realm and being most clearly an  expression of Treason.
I DECLARE that as from and including this present date, and for all such time as may now be required to restore Elizabeth the Queen to Her Freedom and to The Lawful Dignity & Authority of her Crown, I DENY AND WITHHOLD ALL ALLEGIANCE AND OBEDIENCE TO ELIZABETH THE QUEEN, to the precise purpose of providing some defence to Her Majesty’s Person; Royal Estate and Freedoms, by the process of denying all and any lawful recognition to those Evil Persons who now hold Her Majesty captive to their own Treasons; Evil Designs and Unlawful Purposes, contrary to law -
AND TO THE FURTHER PURPOSE that my own Security and Safety under the Rule of those Laws that are my inalienable birthright may be safeguarded against the threats to Freedom & Liberty now being posed by Divers Evil Persons, contrary to law.
I NOW DECLARE to All Persons claiming a legal authority to exercise the power of government, in the name of Elizabeth the Queen that their authority to govern me in any way whatsoever is both denied and ended.
I FURTHER DECLARE to all such persons that my personal freedom comes directly to me from God Himself, and that the walls and doors of all and any prisons now under the control of Traitors to the Crown & People of the United Kingdom will crack wide and will open at the behest of God Himself, if they should seek to impose penalty upon me for my departure from their mischiefs. 
FINALLY, I give Full Notice & Assurance  that I will return to my allegiance and obedience to the Person; Estate & Imperial Crown of Elizabeth the Queen when Her Majesty is entirely released from the bondage that now prevents her from the free exercise of her lawful authority and duty to Govern Her Peoples in accordance with their own laws & customs; which authority requires Her to Defend Her Peoples; Her Kingdoms; Her Realms and Her Territories in full accordance with the terms of the Oath that was Sworn before Almighty God & The People on 2nd June, 1953.
THE COMMON LAW OF ENGLAND is my birthright and at any future time of returning to a condition of Full Allegiance and Obedience to the authority of Elizabeth the Queen, I will require and expect to receive The Queen’s Own Freely-Given Assurance that the government of my country will from that same time be conducted in full accordance with the laws and customs of my people; which laws and customs require and demand that the activities of all and any parliaments and governments of the United Kingdom be constrained to act within those provisions of the law that provide for the existence of such parliaments and governments. 
May God in His Mercy, Defend the Right & May God Save the Queen from those who now hold her in an Unlawful Captivity.





________________  Janet: of the Family Osborne

Before me, An Officer of the Court, or Solicitor
________________________________________
Print Name____________________Date_________
(Signed & Sealed)

Sworn at:_________________________________
________________________________________
________________________________________
________________________________________