Promissory Note Sample

Promissory Note: number: PNTAH000101
Established under House Joint Resolution 192 (HJR 192) (Public law 7310)
Amount: _______$313.98________; On this date ______________,
2017;
Written amount: Three hundred thirteen dollars and ninety eight cents;
Issued from mailing address: 1049 Hill Drive, Reynoldsville, Pennsylvania;
This Certifies that I, TIMOTHY DOE; id number 10000000 hereby
promises to pay, ___Verizon Wireless LLC_, (holder) the full amount
specified on this note, for value received.
Terms and conditions:
The payment will be made in monthly statement (installment) amount of $163.31, per month, on
the 18th of each consecutive month until the obligation has been fulfilled. The payment can be
obtained by the holder from my government created 'Cestui Que Trust' account. I hereby give
permission to the Holder and the Holder in due course to use this Note in any way necessary as a
negotiable instrument to be financially traded on whereas such trade will terminate the obligation
herein.
Date _________________ Signature _______________________________
Notary:________________________ commission expires ____________

Notary number:
Affidavit of Fact: “Bill” already Paid in full

USPO; Certified mail tracking number: _____________________________
To: CFO/CEO of Verizon Wireless LLC; legal department

One Verizon Way
Basking Ridge, New Jersey, 07920
Dear Sir/Madam:
Your July payment coupon of statement (No: # 820460631-00001) is being accepted and
returned for value as consideration for settlement of this account in full for the amount of
$313.98 (written amount: three hundred thirteen dollars and ninety eight cents) principal
balance. It has been noted on the payment coupon that this coupon is a 100% value
coupon and that it is accepted for the value indicated. I wish to thank you for obtaining
the funds from my government created 'CESTUI QUE TRUST' account for me..
The required IRS form 1099-A is attached to document/cover the process of this
transaction, for the funds that you have withdrawn from US Treasury CESTUI QUE
Trust Account – TIMOTHY A HARMON (STRAWMAN;CESTLI QUE TRUST)SSN #
196544105. The 1099-A is so the IRS accounting department can properly account for
the transfer of these funds from this account to your account.
The first item on the 1099-A is for an Acquisition which means for the Lender (buyer,
purchaser, acquirer) and the Borrower (seller, supplier, provider, holder). By the correct
understanding of the form this means that the debt as noted in block 5 is really payment
and this 1099-A is documenting that fact.
So please update my information as well as send me a "True Invoice" of a bill, NOT a

statement of a bill, which is a proper response and your duties to me.
Sincerely (Right Thumb of

Living Wo/Man)
By:___________________________: Date:______________A.D.
Timothy A Harmon (Authorized Representative)
Natural Person, In Propria Person4 Sui Juris
All Rights Reserved 'Without Prejudice U.C.C. 1-207 /1-308/1-103
All Natural Rights Reserved 'Without Prejudice' U.C.C.l-207/l-308i l-103.6 Page I
Affidavit of Fact
A little extra information for you but I am sure you already knew it:
BE INFORMED, any actor agent or fiduciary who delays, restricts, or otherwise

prohibits the movement of this Negotiable Debt Instrument in its lawful progression*
destined to, or for, the Holder In Due Course, Secured Party, or Claimant must show
cause why a contempt charge** should not issue against him/her in his/her/their True
Character, or suffer the consequences of said action, or lack of action.
It is noted that said actors, agents, and fiduciaries are subject to the self-executing
regulations of the 3d and 4e sections of the 14ft Amendment to the Bill of Rights to the
Constitution for the United States of America whereby their offices are vacated and their
salaries and retirement benefits me extinguished when they do not perform the duties of
said offices. * Established in 1933 under HJR 192 and exercised by actors, agents, and
fiduciaries of every commercial transaction by commercial banking institutions since that
date with the "Abrogation of the Gold Clause".
** Damages equal to double the amount of the Negotiable Debt Instrument (under civil
action) or triple the amount of the Negotiable Debt Instrument (under Admiralty
jurisdiction).
Copies of All paperwork shall be forwarded to:
To: U.S. Securities and Exchange Commission (SEC)

Office of Investor Education and Advocacy
100 F Street N.E
Washington, DC 20549 -4213
To: DEPARTMENT OF TREASURY

INTERNAL REVENLTE SERVICE – CID
Austin, TX 73301
To: Consumer Response Center

Federal Trade Commission
Washington, D.C.20580
All Natural Rights Reserved 'Without Prejudice' U.C.C.l-207/l-308i l-103.6 Page 2

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Promissory Note: number: PNTAH000101

Date _ Signature _______________

Notary:____________ commission expires

Affidavit of Fact: “Bill” already Paid in full

To: CFO/CEO of Verizon Wireless LLC; legal department

So please update my information as well as send me a "True Invoice" of a bill, NOT a

Sincerely (Right Thumb of

BE INFORMED, any actor agent or fiduciary who delays, restricts, or otherwise

Copies of All paperwork shall be forwarded to:

To: U.S. Securities and Exchange Commission (SEC)

To: DEPARTMENT OF TREASURY

To: Consumer Response Center

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