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E F T Instrument for Discharge of DEBT

JON D SMITH
8201 MYSTREET - APT 88 ORANGE, CA 92345

J on D Smith
Front of E F T Instrument: NOTE: Account number of statement TOP CENTER MEMO: Copy As Is RED Ink SIGNATURE: BLUE Ink

Back of E F T Instrument: NOTE: ALL COPY AS IS use RED Ink Signature Line: draw in BLACK Ink (Note DATE) SIGNATURE: IN BLUE INK

J on D Smith

1/3/12