CERTIFICATION OF NON-RESPONSE / NON-PERFORMANCE

STATE OF CALIFORNIA COUNTY OF ORANGE PRESENTMENT

Claimant

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ss

Be it known, that, the person signing below, a duly empowered Notary Public, at the request
Address

123 Main Street, Fountain Valley, CA 92708 John Henry Doe of_____________________________ In care of __________________________________________________: PAYOFF TRANSMITTAL FORM (BILL OF EXCHANGE); and June 10, 2009 June 10, 2009 1. did duly present on ________________ the attached ________________________________________________ dated _______________ PAYOFF COUPON JESSE JAMES, CFO, c/o ABC BANK, N.A., 333 BANKERS STREET, SAN FRANCISCO, CA 94163 to _____________________________________________________________________________________________________________
Respondent(s)

John Henry Doe Verified Adjusted Statement of Account signed by ___________________________ requesting _________________________________________________________________, the time limit having elapsed for rebuttal or acceptance thereof, which was refused by non-response/non-performance; and July 10, 2009 July 10, 2009 2. did duly present on ________________ the attached ________________________________________________ dated _______________ NOTICE OF FAULT IN DISHONOR JESSE JAMES, CFO, c/o ABC BANK, N.A., 333 BANKERS STREET, SAN FRANCISCO, CA 94163 to _____________________________________________________________________________________________________________
Respondent(s)

John Henry Doe Verified Adjusted Statement of Account signed by ___________________________ requesting _________________________________________________________________, the time limit having elapsed for rebuttal or acceptance thereof, which was refused by non-response/non-performance. DEFAULT Whereupon, the Notary Public signing below, for the reason dishonor by non-response/non-performance, does publicly and solemnly certify the dishonor as against all parties it may concern for liability equivalent to all costs, damages and interest incurred, or hereafter incurred, by reason of non-response/non-performance thereof and stipulations therein. July 20, 2009 NOTICE The undersigned Notary Public, certifies that on ___________________Notice(s) of Default were sent to the parties noted below by depositing in a depository of the United States Postal Service within the State indicated herein a sealed envelope containing said Notices(s) directed to the respective person(s) or entity(ies) at the last known corresponding address noted below: NAME ADDRESS

JESSE JAMES, CFO _________________________________ c/o ABC BANK, N.A. _________________________________

_________________________________ TESTIMONY

333 BANKERS STREET ________________________________________________ SAN FRANCISCO, CA 94163 ________________________________________________

________________________________________________

In testimony of the above, I have signed my name and attached my official seal

___________________________________________ Notary Public August 24, 2010 My commission expires: __________________ July 20, 2009 Date __________________

CERTIFICATION OF DUE PRESENTMENT OF NOTICE UNDER NOTARY SEAL

Date of Presentment: JUNE 10, 2009

Notice Presented Under Seal: PAYOFF TRANSMITTAL FORM (BILL OF EXCHANGE) DATED JUNE 10, 2009. PAYOFF COUPON. Notarys Certification: The above-noted parties were presented notice under notary seal that certification of non-response or default within thirty (30) days of postmark would comprise their acceptance of the facts set forth within these instruments, the time having elapsed for response thereof. JULY 10, 2009

Date of Presentment:

Notice Presented Under Seal: NOTICE OF FAULT IN DISHONOR. Notarys Certification: The above-noted parties were presented notice under notary seal that certification of non-response or default within ten (10) days of postmark would comprise their acceptance of the facts set forth within this instrument, the time having elapsed for response thereof.