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Finn: Sol

RE: Acceptance by John Henry Doe of complaint on case #12121212 JOHN H DOE

I, Susan Smith, am the notary who verified Dave Brown’s dishonor of John Henry Doe’s Notice of Acceptance, for JOHN H DOE, pursuant to state law regarding evidence of dishonor O.C.G.A. §11-3-505 and §11-1-202.

I certify the following:

____________, the record shows I mailed a NOTICE OF BREACH to Dave Brown at ABC Agency at [ADDRESS}, by certified mail package # {CERT #} RRR, as verified by Certificate of Service.

After acceptance of both mailings, Dave Brown, for ABC Agency, refused to send the confirmation that the account for case # 121212212 has been adjusted and settled, nor a notice of dishonor from a qualified third party excusing his refusal, in the ten (10) days following the second mailing.

Dave Brown, for ABC Agency, did not cure his dishonor. He gave no reason for his refusal to confirm the adjustment and settlement of the account or send a notice of dishonor.

Therefore, based on the foregoing facts, I certify that Dave Brown, for ABC Agency, dishonored John Henry Doe and me through his non-response, and did thereby agree that John Henry Doe accepted the subject complaint for case # 12121212, returned the complaint, exchanged his exemption for the discharge of the associated charges, presented an authorization for the use of his credit to set off all associated court charges, included processing instructions, included a statement of account showing a zero balance, sent a letter of credit to Timothy Geithner as notice that exemption # 123456789 was being used to settle account #12121212.

Further Dave Brown agree that his refusal to send the written confirmation of the settlement of account # 12121212, or notice of dishonor from a qualified third party, in no way negates the fact that said account settled and closed, that he and the agency he represents have no capacity to pursue collection on said account, and that further pursuit of collection is agreement that Dave Brown and ABC Agency collectively and severably owe JOHN H DOE $5000 for expenses of handling Dave Brown’s presentment and that JOHN H DOE may take all necessary steps to secure its claim to the debt owed to it and to collect.


Dated: ______________ (seal)



Notary Public




Susan Smith, Notary Public




Void Where Prohibited by Law