(EXAMPLE)
TRAFFIC TICKETS
Registered Mail ____________________________________ Date
Jack Rabbit Patriot
P.O. Box 8800
Wolf, Texas [75000]
Ref. ss# 000-00-0000
Docket/Account Number: Identifying number on their documents
Traffic Ticket
AGENTS for the PLAINTIFF THE STATE OF TEXAS
BAD BOY WOLF - MAYOR of WOLF CITY
P.O. BOX 7777 - WOLF CITY, TX 75 71 0
AGENTS for the PLAINTIFF THE STATE OF TEXAS
CLERK OF THE MUNICIPAL COURT (OR COURT TO BE HEARD IN)
P.O. BOX 666 - TYLER, TX 75710
Bond to discharge attachment for debt for
DOCKET/Account #: Identifying numbers of document
1, Jack Rabbit Patriot, principal, surety, owner is held and bound to pay AGENTS for the
PLAINTIFF ____________ dollars (to be filled in by AGENTS for the PLAINTIFF), unless the
said Defendant JACK R PATRIOT© shall satisfy any judgment which may be recovered against
him by the said AGENTS for the PLAINTIFF, in their attachment against said defendant
PATRIOT, JACK R© for __________ dollars (to be filled in by AGENTS for the PLAINTIFF),
for discharge of said (Identifying number on the document) recorded by AGENTS for the
PLAINTIFF and returned - On the (date you return the bond)..
________________________________________________
By me, Jack Rabbit Patriot, a man holder in due course, principal, surety, owner
Negotiate this item through the back office for settlement via the pass through account of the treasury
window
Department De Hacienda Secretary of the Treasury
Manuel Diaz Saldana P.O. Box 4515 San Juan,
Puerto Rico, 00902
A dishonor of the above bond is sedition against the united States of America Treasury
Jack Rabbit Patriot
