( Your Name Here )
c/o postal service address
( Your Address Here )
( City, State, CFZip CodeCF )
License # / Account
No. Xxxx-xxx-xx-xxx-x
State of Florida
Department of Motor Vehicles
100 Speedy Street
CantCatchMe, Florida 00000
RE : Notice & Praecipe , Contract , Termination
Greetings :
You will please take notice that I recently discovered that there
are certain political liabilities which attach to the above numbered
driver's license account which, if they had been fully disclosed to
myself at the time I was induced into said Consent contract ,
would have dissuaded me from Consenting to the same. As
evidenced by the enclosed wallet card , which is being returned to
you , said Consent contract is " expired " on its face. For these
reasons and on the basis I am hereby expressly terminating said
Consent contract and do hereby rescind my signature from the
Declared Void and any and all forms , cards , Instruments which
may evidence anything to the contrary. My sovereign Consent is
hereby expressly withdrawn and reserved until further notice.
You will also forthwith please notify any and all interested parties
of this termination action as well as direct / order that all forms ,
cards , documents , Instruments bearing my signature in
connection with said account be amended to well and truly reflect
this change. No answer to this instruction is required , but
acknowledgment of compliance would be appreciated.
To the event you are unable or unwilling to comply with this
instruction , I shall alternatively require of you evidence of your
Article VI Oath of Fidelity as well as the Policy Number and
Name and Address of the Underwriter of your Bond.
Respectfully ,
nunc pro tunc
( Your Signature Here )
( Your Name Here )
( State ) Elector
1 enclosure :