Certified Mail #
American Private Bank – US/SS Treasury DRAFT
PATRICK DEVINE PRIVATE BANK E & T
c/o Independent Banker/Fiduciary Patrick Devine
18463 – 208th Avenue
Sigourney, Iowa 52591-8236
Original Issue
Tracking Number: 1001
Date: _____________________
for: $ - _____________
Released for Processing to the: United States Treasury
FOR: negative
DOLLARS
Processing Obligation: United States Department of the Treasury
from the United States Independent - SS “Off-Shore MORTMAIN” Treasury
by way of the Social Security Bank and Trust Administration.
By:
Authorized Representative (per IRS/Treasury form 56)
Memo: _______________________________________________________________ .
Valid per the U.S. Treasury/Banking Laws
US/SS Treasury/Bank Routing #:
1001
US/SS Account #:
Certified Mail #
American Private Bank – US/SS Treasury DRAFT
PATRICK DEVINE PRIVATE BANK E & T
c/o Independent Banker/Fiduciary Patrick Devine
18463 – 208th Avenue
Sigourney, Iowa 52591-8236
Original Issue
Tracking Number: 1002
Date: _____________________
for: $ - _____________
Released for Processing to the: United States Treasury
FOR: negative
DOLLARS
Processing Obligation: United States Department of the Treasury
from the United States Independent - SS “Off-Shore MORTMAIN” Treasury
by way of the Social Security Bank and Trust Administration.
By:
Authorized Representative (per IRS/Treasury form 56)
Memo: _______________________________________________________________ .
Valid per the U.S. Treasury/Banking Laws
US/SS Treasury/Bank Routing #:
1002
US/SS Account #:
Certified Mail #
American Private Bank – US/SS Treasury DRAFT
PATRICK DEVINE PRIVATE BANK E & T
c/o Independent Banker/Fiduciary Patrick Devine
18463 – 208th Avenue
Sigourney, Iowa 52591-8236
Original Issue
Tracking Number: 1003
Date: _____________________
for: $ - _____________
Released for Processing to the: United States Treasury
FOR: negative
DOLLARS
Processing Obligation: United States Department of the Treasury
from the United States Independent - SS “Off-Shore MORTMAIN” Treasury
by way of the Social Security Bank and Trust Administration.
By:
Authorized Representative (per IRS/Treasury form 56)
Memo: _______________________________________________________________ .
Valid per the U.S. Treasury/Banking Laws
US/SS Treasury/Bank Routing #:
US/SS Account #:
1003
By: _____________________________________________
By: _____________________________________________
By: _____________________________________________
Authorized Endorsement as a Public Trustee
per W-8BEN – EIN # ______________
For Asset value conversion to Lawful Currency.
Authorized Endorsement as a Public Trustee
per W-8BEN – EIN # ______________
For Asset value conversion to Lawful Currency.
Authorized Endorsement as a Public Trustee
per W-8BEN – EIN # _______________
For Asset value conversion to Lawful Currency.
For Final Deposit as a positive value into my
DIRECT EXPRESS SS Treasury DEBIT account:
Account #
U.S. SS Treasury Settlement Obligation per the
American Laws of Equity and Mortmain Tort.
For Final Deposit as a positive value into my
DIRECT EXPRESS SS Treasury DEBIT account:
Account #
U.S. SS Treasury Settlement Obligation per the
American Laws of Equity and Mortmain Tort.
For Final Deposit as a positive value into my
DIRECT EXPRESS SS Treasury DEBIT account:
Account #
U.S. SS Treasury Settlement Obligation per the
American Laws of Equity and Mortmain Tort.