Updated 04/09/05

Updated 04/09/05

Notice of Surrender, Rescission, and Termination of Fiduciary Responsibility

Instructions

This is the first and only notice you send to the banks. If you still have the credit cards, return them with the notice. If you do not have the credit cards, don't worry about it.

Postage Information:

Certified Mail Receipt Number:

This is important. This notice must be mailed certified. This gives you proof of mailing.

You can pick up the Certified Mail Receipts at the post office. Get a stack.

Each Certified Mail Receipt has a unique number. Enter that number in this space.

Bank Information:

Name of Bank:

The first thing you need is the name of the bank that issued the credit card. It should appear on your statement.

Name of Bank Officer:

If you still have a copy of the agreement the bank sent you with your credit card it should have the name of an officer at the very end. If not, call customer service, the number will be on your statement, and ask for the name of a bank officer. If nothing else, ask for the phone number of the banks headquarters. Then call that number and get the name of the CEO. Look at the bank's website. Look on the forum. There are information resources available you can use.

You cannot use just any old name. An employee, manager, or supervisor will not do. It must be an officer, Vice President, President, CEO, Chairman of the Board, etc.

If you cannot find this information, or you just don't care to try, leave it blank.

Mailing Address:

This is not the address you mail your payments to. It is the address for payment disputes. It should be shown on your statement. It may also be called "customer service." Do Not mail the NOS to the corporate headquarters.Credit Card type:

Visa, MasterCard, Discover, etc.

Card number:

I think you can figure this out for yourself.

Your Information

Full Name

Enter your name exactly as it appears on the statement.

Address, City, State:

Enter the address where you want your correspondence sent. Make sure you spell out the name of your state. This is important. It is used in the Notary section and must be spelled out.

Notarization

This document must be notarized. So, don't sign it until you are in front of the Notary.

You can find notaries at most insurance agencies and banks. AAA also has notaries in their offices. Look in the yellow pages.

Filing

This document need not be filed with the County Recorder/Clerk.

Mailing

Once the document is notarized, have a copy made. You mail only the copy. Keep the original for your records. Do this with all the documents in this process.

Department of the Treasury, Internal Revenue Service, Form 56

This form is referenced in the NOS. A copy must accompany the NOS. This form must be completed separately.

See separate instructions under Form 56 on how to complete this form.

The actual document starts below:

Certified Mail Receipt Number: Receipt NumberNOTICE OF SURRENDER, RESCISSION, AND TERMINATION OF FIDUCIARY RESPONSIBILITY

Reference: Account Number: Credit Card Account NumberTo:Bank Officer Name

Bank Name

Bank AddressBank Address 2

Bank City, State Zip

Pursuant to the Federal Rules of Evidence 201 (d) and the corresponding state rule please take notice the following facts:

1. Declaration of Independence.

2. Constitution for the United States of America

3. Yick Wo v. Hopkins, 118 US 356, 370.

4. The undersigned rescinds any signatures associated with the above referenced account.

5. The undersigned surrenders the agreement, credit card, and account between Bank Name and the fiction ALL CAPS NAME ON STATEMENT back to their creators and rightful owners.

Surrender: To give back; yield; render up; restore; Black's Law Dictionary, Sixth Edition, pg. 1444.

6. (Bank Name) has nothing at risk and has not lent Your Name Here in upper and lower case) or ALL CAPS NAME SHOWN ON BANK STATEMENT) any of its money. The alleged account was funded by (Your Name Here in upper and lower case)'s application. See Federal Reserve Bank of Chicago's publication "Modern Money Mechanic."

at page 6: "What they do when they make loans is to accept promissory notes in exchange for credits to the borrower's transaction accounts. Loans (assets) and deposits (liabilities) both rise by $9,000. Reserves are unchanged by the loan transactions. but the deposit credits constitute new additions to the total deposits of the banking system."

at page 7: "Loans are made by crediting the borrower's deposit account, i.e., by creating additional deposit money."

7. Your Names in Upper and Lower Case no longer accept any fiduciary responsibility for the fiction ALL CAPS NAME ON STATEMENT in the instant accounts. Please see the attached Form 56.

8. Any further contact by Bank Name or any of its agents with Your Names In Upper and Lower Case will be considered harassment and attempted extortion through violence. These threats will be dealt with in an appropriate manner.

Affidavit

State of Your State }

} ss:

County of Your County}

I/We, Your Name and Spouse's Name, hereafter I/We, am/our competent to testify by first hand knowledge do hereby affirm that:

I/We live at Your Address (leave out zip code).

I, Your Name, am a man.

I, Your Spouse's Name, am a woman.

I/We have never represented ourselves using an all caps name.

I/We surrender back to their creators and rightful owner, (Bank Name) the (Name of Credit Card) its account and agreement.

I/We no longer accept any fiduciary responsibility for the above referenced credit card, account or agreement.

The attached copy of Form 56 is true and accurate.

Further affiant saith naught.

I/We, Your Name(s), knowing the penalty of bearing false witness, hereby affirm the foregoing to be true and correct to the best of my/our knowledge and belief and do affix my/our signature in testimony of the foregoing notice.

EXECUTED THIS ______ day of Month, Year________________________ and ______________Your Name and Spouse's Name, Your AddressYour City, State ZipSignatory, Your Name and Your Spouse's Name , personally appeared before me and is/are known to me and did affix his and her signature to this document. In witness thereof I set my hand and seal

_____________________________________________

Notary Public in and for the State of Your State.

My commission expires: