[quasimodo]

Signed by Respondent under penalty of perjury under the laws of the State of TEXAS:

Respondent’s signature_________________________________________ ________________

Date, _________________

Print name and title of Respondent _______________________________________________

Respondent must timely complete and return this Disclosure Statement, along with all required documents referenced herein, as follows:
In care of:
_____________________________________, Notary Public

______________________________________

______________________________________

Respondent’s claim will be considered only if all portions of Debt Collector Disclosure Statement are completed and returned within the required time frame for response, with all required documents, specifically including the requisite verification made in accordance with law and codified in the Fair Debt Collection Practices Act at Title 15 USC §1692 et seq., which states in relevant part: “A debt collector may not use any false, deceptive, or misleading representation or means in connection with the collection of any debt,” which includes “the false representation of the character, or legal status of any debt” and “the threat to take any action that cannot legally be taken,” each of which is a violation of law. If Respondent does not respond as required by law. Respondent’s claim will not be considered, and Respondent may be liable for damages for any continued collection efforts and, or reporting of such accounts, as well as for other injury sustained by Secured Party. Please allow thirty (30) days for processing after receipt of Respondent’s response.


Honorably, through use of right to remedy.
WITHOUT RECOURSE, WITHOUT PREJUDICE


By:_______________________________________________
Me,

All Rights Reserved