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Certificate of Service Bank

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CERTIFICATE OF SERVICE 2017

D O E E S TAT E T R U S T
CERTIFICATE OF SERVICE
Republic of California )
Subscribed and Affirmed )
County of San Diego )

I, Doc - Daniel: Family of Holiday, the undersigned mailer/server, being of sound mind and under no duress, do hereby
certify, attest and affirm that the following facts are true and correct, to wit:

1. That, on the January 18, 2017, that, on behalf of (name) JOHN MICHAEL SMITH, the undersigned personally
deposited the following documents (listed below) inside the envelope, sealed them and transmitted them via the carrier
indicated in item 2 below, to wit:

Item
 Document Description Number 



# of pages
1 Certificate of Service 1

2 Affidavit of Negative Averment 4


3 Bill of Conveyance 2
4 APN Letter 1
5 Revocation of Election 4
6 Secured Promissory Note 1
7 UCC1/UCCad 2
8 Promissory Note 1
9 Security Agreement 2
10 1099 A and 1096 2
11 1099 OID and 1096 2
12 1040 2
13 Surety Bond 1
14 Acknowledge of Final Payment 1

Total of 14 documents with combined total of 26 pages.

2. That I personally mailed said document(s) via (initial those which apply):
_______United States Postal Office, by regular mail, postage prepaid
___X__ United States Postal Office, by Certified Mail #
_______Return Receipt Requested
_______United Parcel Service (UPS), tracking number # _____________________
_______Federal Express, tracking number # ____________________
___X__ Other (specify): RExxxxxxxxxUS, RExxxxxxxxxUS, RExxxxxxxxxUS

at said City and State, one (1) complete set of COPIED documents, as described in item 1 above, properly enveloped and
addressed to (addressee and address):
3. That I am at least 18 years of age;
4. That I am not related to JOHN MICHAEL SMITH, by blood, marriage, adoption, or employment, but serve as a
“disinterested third party” (herein “Server”); and further,
5. That I am in no way connected to, or involved in or with, the person and/or matter at issue in this instant action.
I now affix my signature to these affirmations.
(Signature): _______________________________________________________, Mailer/Server
(Printed name): Doc-Daniel Family of Holiday

1! DOE Estate / Trust | Private and Confidential

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