I have information pertaining to this on PDF. Have a read as this may help you relate.
Latest “ACCEPTED FOR VALUE” Formats:
When you receive a “PRESENTMENT” from anyone (that you have a standing contract with, example account
with SS# tied to it) – disregard the concept of a “BILL” you need to pay. That will give you confidence. Realize you don’t
owe anyone anything. When your account was set up you gave them some large amount of money from your account and
they’ve never compensated you for it.
Look at the “BILL”. Notice there’s a top portion and a bottom “stub” or “payment coupon” – the portion that gets
torn off where it says “detach and send with payment.”
To process an “Accepted for Value” formatted item, you always need two instruments, the top of the statement
and the bottom of the statement or coupon. (If you pay a $40.00 bill with 2-$20’s; you’ve just sent in 3 instruments, 2-
$20’s and the coupon. That’s beyond the 2 instruments required by 1.
NEVER SEND the UPPER AND LOWER parts of the STATEMENT (your 2 instruments) back in the RETURN
ENVELOPE THEY’VE PROVIDED for YOU. ALWAYS USE YOUR OWN ENVELOPE AND MARK on the
OUTSIDE of the envelope “Private and Confidential”, in red, and to the left side of the (TO: address) and under your
return address, put Priority/Confidential, send “Registered Mail with electronic signature confirmation service requested”
OR “Certified/Registered with return Receipt Requested” and mail to the CFO (Chief Financial Officer) of the company
you’re tendering your “Accepted for Value” payment documents to.
Could also do the following, I would:
1) Cover Letter - send it to the billing origination CFO or someone over your account(s)
2) Fiduciary Contract, with the Form 56 attached; making the CFO or someone Fiduciary of your the account(s).
3) 1040V with all A4V’s.
[KEEP COPIES OF EVERYTHING YOU SEND OUT].
SPECIAL NOTE: If you want to keep the Credit Card Account OPEN – DO NOT make the
payment for the Full amount that you Owe, make it like $10 less.
FORMAT #1 – To MAKE PAYMENT; but Not to Shut Down/Close the Account (i.e., your power bill, water bill).
1. A4V Statement angled corner to corner on the top of the bill (IN RED):
Accepted For Value and Returned For Value
Date:______*, Exemption #_________**
_______________signature________ (do not put Auth. Rep.)
* use date of birth (this date is for the inception of the signature of your Certificate of Live Birth”)
**The Exemption # is found on the back of your SS card, it’s your Bond #. It begins with a Letter then 8 numbers. For
example: A12345678. (If your SS card doesn’t have a number on the back, you need to go apply for a new card.
http://www.ssa.gov/online/ss-5.pdf )
2. Take the COUPON/PAYMENT STUB you tore off and in the LOWER RIGHT HAND CORNER, above any
numbers that may be there, Sign your “Certificate of Live Birth” name.
3. Find the box where you would write in what amount you’re paying. Pay the total of the invoice; plus add in
EXTRA DOLLARS, so that they can’t close the account.
4. TURN the COUPON/PAYMENT STUB OVER and ENDORSE the BACK as you would a check including
“Authorized Representative.”
FORMAT #2 – To Close Out/Pay Off an Account (i.e., pay off car, credit cards, mortgage).
1. A4V Statement corner to corner angle on top of statement (IN RED):
Accepted For Value and Returned For Value
For Settlement, Closure and Setoff
Date:______*, Exemption #_________**
____________signature________ (do not put Auth. Rep.)
2. It is best to contact the company and ask for a PAY-OFF presentment. Then you a Statement to put the A4V
wording on.
3. If the PAY-OFF presentment does not have a coupon on the bottom that’s okay, just put the wording A4V on and
attach a $1.00 bill. (covers the 2 instruments needed)
4. If this is a purchase that you’ve put a down payment down on, then the contract is binding and you can A4V right
away. If you’ve NOT put anything down at the time of purchase, you MUST wait 30 DAYS for the contract to
cure. After the 30 days curing, wait another 2-3 weeks then do the A4V process.
FORMAT #3: Statement with no coupon.
1. A4V Statement angled corner to corner on statement (IN RED):
Accepted For Value and Returned For Value
(For Settlement, Closure and Setoff) if it applies
Date:______*, Exemption #_________**
____________signature________ (do not put Auth. Rep.)
2. Send back with $1.00 FRN.
FORMAT #4: IRS issues - (with or without a coupon).
1. A4V Statement angled corner to corner on presentment (IN RED):
Accepted For Value and Returned For Value
For Settlement, Closure and Setoff
Date:______*, Exemption #_________**
________________signature________ (do not put Auth. Rep.)
2. Take a 1040V for the YEAR that the presentment refers too, SIGN in lower right hand corner like a check. Fill in
the amount plus extras dollars so they have to send you a refund check. Make it payable to: Department of
Treasury.
3. Endorse the back of the 1040V:
By: (your name)___________Auth. Sig.
For Settlement, Closure and Setoff of this Presentment
Payment/Exemption #________(from back of SS card)
4. Send to the Top Person at the Agency. [you choice on addresses] I like the last two.
(Kansas City, for IRS, is supposedly the best for getting them accepted).
(Or IRS, Stop 4440, PO Box 9036, Ogden, UT 84201)
***Presentments for all years except 07 & 08 – IRS, Fresno Campus, ASFR Unit Stop 81404, Po Box 24015,
Fresno, CA 93779
***Presentments for years 07 & 08 – IRS, ACS Support Stop 76202, Po Box 24017, Fresno, CA 93779
NEVER write your Social Security number with NO dashes on an A4V statement.
There has never been a BILL; that you were supposed to pay, but you were never told this.
You are the Surety; they are taking their money from you as collateral. You’re paying them twice; if you pay any BILL
with anything other than YOUR “Certificate of Live Birth” SIGNATURE on the public side.
The reason we do this is because we are giving the CFO permission to access our DTC account and get “asset” funds to
offset the “debt”. FRN’s are liability and public funds, and are just another debt.
We are allowed to do this under the contract we signed with our signature and SS #, for services or whatever.
The CFO is allowed to go to the DTC to offset the account. If you pay by check, money order, etc, you are paying with
public/liability funds and the CFO will do a 1099-A on the abandoned credit you neglected to “claim, and you’ll have paid
them twice. The CFO is licensed to do an ACH transfer from the private side of the DTC, he’s getting “real” money.
IF THEY DON’T CREDIT THE ACCOUNT with one of the Above A4V PROCESSES AND VOUCHER, THEN
SEND IT BACK WITH A FORM 28 ONLY. THEY CAN’T REBUT THE AFFIDAVIT, AND IT STANDS AS
GOOD UNDER CONTRACT LAW.
OR
Follow-up with:
[This item can be done now or later] Send them the following items to address the settlement of past payments made
out of your back pocket - 2nd payment and you demand settlement (three years for everything not tied to a promissory
note) or (from life of contract signing if it was under a promissory note); [understand these forms before you use them
please]
a. 1099-A (for each year you made payments out of your back pocket)
b. 1099-OID (them as the Payer and the amount that has WITHHELD from you)
Always TIE these forms together so they cannot be separated. (tie - means to refer to each document on
each one)
c. Sf-28 - AFFIDAVIT OF INDIVIDUAL SURETY
d. Op-90 - RELEASE OF LIEN ON REAL (ONLY IF NEEDED)
e. Op-91 - PROPERTY RELEASE OF PERSONAL PROPERTY FROM ESCROW
IF they still do not accept and settle, then file a 3949A IRS form on them and send the package to
the IRS/CID.
This is one place to send to CID !! Check them all out though.
INTERNAL REVENUE SERVICE
CRIMINAL INVESTIGATION DIVISION
BOX 192
COVINGTON, KY 41012

Do you have a pdf link so I could read the whole document?

RE: Doug.
When using the bond number on back of SSC the fact that they may have issued more than 1 to someone (like myself) and each card the Bond # changes. That being said if I was using a bond # from a card issued 1/19/2010 would I not want to put the date as 01/19/2010 instead of my birth year 1973?

I attach a fee schedule, if they close my account without my knowledge and approval, they will owe me $1M