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Notice of Validation

Your Name in Upper & lower case

City, State, Zip





ACCOUNT #: ________

I am in receipt of your _______________ letter dated ____________.

It is not now, nor has it ever been my intention to avoid paying any obligation that I lawfully owe. In
order that I can make arrangements to pay an obligation which I may owe, please COMPLETELY
document and verify the “debt”, in which you reference to the above account. In regards to this alleged
debt, I am sending this letter to request the following documented information from your company:

I would like this agency to provide me with the following information in accordance with the “Fair Debt
Collection Practices Act” [15 U.S.C. 1692 et seq.]

1.) The original or certified copy (NOT a photocopy) of the parse syntax grammar document
contract signed by the authorized representative of your agency and autographed by myself,
that each individual entered into knowingly, intelligently, with full disclosure, and with a
meeting of the minds saying that I owe you or your agency payment of this alleged debt, with
both your agencies authorized representative’s wet ink signature and my wet ink signature.
2.) Proof that this debt has not been “wrote off” to an insurance company and claimed as a
“business loss” and redeemed through an insurance claim by the original creditor.
3.) Proof that this debt has not been sold to your agency for a lesser amount, and if so the amount
your company purchased the alleged debt for.
4.) Your agencies license to lawfully and legally collect debt in the state of Minnesota and provide
me with your agencies license number.
5.) Validation of the alleged debt (the actual accounting showing a loss to your agency) and the
CUSIP number of the alleged debt along with a copy of a completed W-9 and Total Amount Due
6.) Verification of your agencies claim against me (either a sworn affidavit or a hand-signed invoice)
7.) The original or a true and certified copy (NOT a photocopy) of the Original Note or Promissory
Note (Credit Agreement) under penalty of perjury, that I have with your agency showing my
agreement to pay to your company this alleged debt.
8.) The name of the authorized representative from your agency who has carried out due diligence
and what actions s/he has taken in regards to this alleged debt.
9.) The contract between your agency and the original alleged creditor saying they gave your
agency authority to collect the alleged debt with both agencies authorized representatives wet
ink signature.
10.) Proof that I was given FULL disclosure of any contract signed between your agency and
myself, and/or proof I was given FULL disclosure of any contract signed between your agency
and the alleged creditor.
11.) Also, pursuant to P.L. 93–579, Approved December 31, 1974 (88 Stat. 1896) Privacy Act of 1974
SEC. 7. [5 U.S.C. 552a note] "(b) Any Federal, State, or local government agency which requests
an individual to disclose his/her social security account number shall inform that individual
whether that disclosure is mandatory or voluntary, by what statutory or other authority such
number is solicited, and what uses will be made of it."
I, hereby demand FULL disclosure of why the social security number assigned to me is used by
this agency and what the purpose is this agency uses the social security number.
12.) The process of how your agency calculated in the fees and interest attached to the alleged
debt, if any, and the proof of where I agreed to pay such fees and interest.
13.) Proof the Statute of Limitations has not expired on this account.
14.) Verification, if any, that your agency did or did not purchase alleged debt from another debt
collection agency.
15.) Verification, if any, of tax deductions and/or tax-write offs made by your agency or any alleged
creditor in regards to this alleged debt.
16.) Any derogatory reports made by your agency to any credit bureau agency.
17.) Verify that there is available “lawful” “money” to actually “pay” alleged “debt” as per the
Constitution for the United States, Article 1 section 10 Clause 1.
18.) If the original creditor is a government agency, (i.e. County, state, municipal court) please
provide proof that they are following their oath of office to uphold the Constitution for the
United States of America by only asking for gold or silver coin for payment of this debt as per
Article 1 section 10 Clause 1 of the Organic Constitution for the United States of America.
19.) Please send me information on my common law remedy to lawfully pay this alleged debt if
found that I do lawfully owe any debt to your agency, and my remedy to lawfully “pay” this
20.) Please send me any verification that “Federal Reserve Notes” is “lawful” “money” that can be
used to actually “pay off” this alleged debt.
Please be advised, if your agency has reported invalidated information to any of the major Credit
Bureaus, said action might constitute fraud under your Federal and State Laws. If any negative marks are
found on any of my credit reports by your agency, this may result in a legal action against you or your
agency for the following:

 Violation of the Fair Credit Reporting Act

 Violation of the Fair Debt Collection Practices Act

Also, if your agency continues to attempt to collect any alleged debt, that I do not legally or lawfully owe
to your agency that could constitute as:

 Violation of U.S.C. title 18 Section 872; attempts to extort

 Violation of U.S.C. title 18 Section 1341, 1342; Fraud and swindles, use of fictitious names
through postal services (Addressing alleged debtor by improperly spelled name/ALL


Notice is hereby given that, until your agency can provide ALL requested documentation and
information to validate this alleged debt, your agency must cease and desist from any further collection
activities on this alleged debt in accordance with the Fair Debt Collection Practices Act laws of your
United States Codes.

If and when your agency provides me with ALL of the information requested above, I will require at least
30 days to investigate and verify ALL information provided.


The use of any statutes, codes, rules, or regulations by this alleged debtor, shall not be construed by
your agency or any other person(s) or agencies that alleged debtor has submitted to, or entered into any
jurisdiction of any agency or other person(s).

I do not give your agency consent to contact me by phone, I will be in contact with your agency only by

If your agency cannot produce all said information stated above and/or does not respond to this letter
within 21 days, a dishonor has occurred and you agree to the following,

1.) The alleged debt did not exist in the first place; OR
2.) The alleged debt has already been paid in full;
3.) There is not and never was a contract binding your agency and myself that was entered
knowingly and intelligently stating I owe such alleged debt;
4.) Any negative remarks made to a credit reference agency in regards to this alleged debt will be
immediately removed;
5.) You or your agency will no longer pursue this matter, you or your agency will offset the balance
of this alleged debt to zero (0.00) and close this account;
6.) I reserve the right to discharge this debt for an amount I believe is satisfactory for closing this
account, the amount I send will be non-negotiable by your agency, you agree not to dishonor
and refuse payment, you agree to accept for value the amount paid unto you to close this
account, ONLY if your company can produce the information requested above;
7.) You or your agency agree to pay all fees and interest;
8.) Any liens against alleged debtor will be removed immediately and verification of removal will be
sent to alleged debtor notifying alleged debtor of removal.

No assured value, No liability. Errors & Omissions Excepted. All Rights Reserved. WITHOUT PREJUDICE –

_____________________________________________ ________________________

Sincerely, Your Name Date

On the _____ day of ________ 2017, Your Name (Upper and Lower case) personally appeared
before me in ________________ County of Your State and placed his/her signature above.

__________________________________________ Seal:
Notary Signature