State of
) ss.
I am over 18 years of age and not a party to
the within action; my mailing location is:
c/o
Post Office Box 373
Loma
Linda [CA 92354]
On this _______ Day of _______________ in the
Year of our Lord two thousand Two I served the following:
·
Confirmed Actual and Constructive Notice, one Duplicate, two
(2) pages;
and California Notary Acknowledgment, one Duplicate, one
(1) page, a total of three (3) pages; and,
·
Bill of Exchange, one Duplicate, two
(2) pages;
with
Attachments:
·
STATE OF WISCONSIN DEPARTMENT OF HEALTH AND FAMILY
SERVICES Certification of Vital Record: STATE OF WISCONSIN DEPARTMENT OF HEALTH
AND SOCIAL SERVICES ORIGINAL CERTIFICATE OF MARRIAGE [GROOM NAME: Gunnar Anders
Smars Jr., & BRIDE NAME: Laurie Ann Hirssig],
with superimposed stamp signed and dated by Gunnar Anders Smårs Jr, one
Duplicate, one (1) page.
A total of six (6) pages, plus a Form 1040-ES
to be completed by the Respondent, including, but not limited by, all attachments
(not including this
Affidavit of Service and its Acknowledgement
page, one Duplicate, two (2) pages), are being served by this United States
Postal Service Registered Mail #RA 029 924 832 US, in a sealed envelope with
postage pre-paid, properly addressed to the Secretary of the Treasury as follows:
Paul H. O’Neill
Secretary of the Treasury
Department of the Treasury
I declare under penalty of perjury under the
laws of the state of
__________________________________
State of
) ss.
On this ______ Day of
___________ in the Year of our Lord ________ before me, Lillian V. Miller,
Notary Public, appeared
WITNESS my hand and official
seal.
____________________________________
Signature of Lillian V.
Miller, Notary Public
