American Civics Research Library
DEBT COLLECTOR DISCLOSURE
STATEMENT
Re “Offer of Performance”
This
statement and the answers contained herein may be used by Respondent, if
necessary, in any court of competent jurisdiction.
Respondent:
John Doe
c/o P.O. Box 1234
Anytown, Anystate 99999
Debt Collector:
DEBT COLLECTION, INC.
P.O. Box 12345
ANYTOWN, ANYSTATE, 99999
Re: MBNA AMERICA BANK, N.A. Acct. # 9999 9999 999 9999
Hello:
This is a request for validation. Please be advised that I am not refusing to pay, but I need the information requested in this correspondence before I can make any offer to settle this account. I would like to settle it as soon as possible and I may have a counter claim to set-off the disputed balance, this is why I am sending you these questions. Please answer the following questions relating to the disputed account and return them to me within thirty (30) days.
This Debt Collector Disclosure Statement is not a substitute for, nor the equivalent of, the hereinabove-requested verification of the record, i.e. “Confirmation of correctness, truth, or authenticity, by affidavit, oath, or deposition” (Black’s Law Dictionary, Sixth Edition, 1990), re the alleged debt, and must be completed in accordance with the Fair Debt Collection Practices Act, 15 USC §1692g, applicable portions of Truth in Lending (Regulation Z), 12 CFR 226, and demands as cited above in Offer of Performance. Debt Collector must make all required disclosures clearly and conspiciously in writing re the following:
4. What was the account number of the account in which the funds were held prior to the opening of the account that is the subject matter of this collection?
5. Who was the owner of each account or, list those individuals having signature rights to each account?
6. Identify the account that was debited when the disputed account was created.
7. Who was the owner of each account or, list those individuals having signature rights to each account?
8. Identify the source of the funds that created the disputed account.
9. Did the funds for the disputed account originate from another account or lending institution?
10. List the names and addresses of all lending institutions from which any funds were purportedly originated.
11. Please identify the account number from which the funds originated in order to create the disputed account.
12. Admit that no other account was debited when the disputed account was created.
13. If you denied that no other account was debited when the disputed account was opened or created, please identify the account that was debited by account number and the name or names of the debited account’s signer, holder and/or owner, and explain how the funds for this account were originated.
14. If you denied that no other account was debited when the disputed account was opened or created, state the total balance of this debited account at the time the debit was made and, list the names of the signers on the account and the date that the account was opened along with the opening balance.
15. Admit that MBNA AMERICA BANK, N.A. was the depositer for the account that is the subject matter of this collection.
16. Please produce all documents and information, related in any way, to your implication or allegation that a loan was given to the defendant.
17. Which employee of the bank authorized the transaction?
18. If any loan origination system, software or other procedures were used in the opening of the disputed account, please identify the system by name and describe how it works.
19. According to the alleged loan agreement, was the purported lender or financial institution involved in the alleged loan to use their money as adequate consideration to purchase the promissory note from the alleged borrower? YES or NO.
20. According to the bookkeeping entries, did the purported lender or financial institution involved in the alleged loan to use their money as adequate consideration to purchase the promissory note from the alleged borrower? YES or NO.
21. According to the alleged loan agreement, was the purported lender or financial institution involved in the alleged loan to accept anything of value from the alleged borrower that would be used to fund a check or similar instrument in approximately the amount of the alleged loan? YES or NO.
22. According to the bookkeeping entries, did the purported lender or financial institution involved in the alleged loan accept anything of value from the alleged borrower that would be used to fund a check or similar instrument in approximately the amount of the alleged loan? YES or NO.
23. Was the intent of the purported loan agreement that the party that funded the loan should be repaid the money lent? YES or NO.
24. Did the purported lender involved in the alleged loan follow Generally Accepted Accounting Principles, GAAP? YES or NO.
25. Were all material facts disclosed in the written agreement? YES or NO.
26. What is the name and address of any bank auditor or certified public accountant involved with or having any relation to the accounting function regarding the disputed account?
27. Identify the name of the records or system of accounting records or ledgers reflecting the transaction for the disputed account.
28. Were any loan numbers assigned to the disputed account?
29. If you answered yes to the above question, please list those account numbers.
30. Explain how each account was created or originated.
31. Explain how the funds for each account were deposited and where they orignated.
32. Was an account created with the purported loan amount then debited to fund the disputed account?
33. Please explain your answer to the above question.
34. Please produce all records and tangible evidence relating to the questions herein and send them along with your response.
35. Re this alleged account, if Debt Collector is different from alleged Original Creditor, does Debt Collector have a bona fide affidavit of assignment for entering into alleged original contract between alleged Original Creditor and alleged Debtor?
36. Did Debt Collector purchase this alleged account from the alleged Original Creditor? YES NO N/A (Not Applicable)
37. If applicable, date of purchase of this alleged account from alleged Original Creditor, and purchase amount:
Date:...............................................................Amount. $....................................................
38. Did Debt Collector purchase this alleged account from a previous debt collector? YES NO N/A
39. If applicable, date of purchase of alleged account from previous debt collector, and purchase amount.
Date:...............................................................Amount. $....................................................
40. Regarding this alleged account, Debt Collector is currently the:
(a) Owner; (b) Assignee; (c) Other-explain:...........................................................................
41. What are the terms of the transfer of rights re this alleged account? .................................................................................................................................
42. If applicable, transfer of rights re this alleged account was executed by the following method:
(a) Assignment; (b) Negotiation; (c) Novation; (d) Other - explain: .............................................. ....................................................................................................................................................
43. If the transfer of rights re this alleged account was by assignment, was there consideration? YES NO N/A
44. What is the nature and cause of the consideration cited in #43 above?
45. If the transfer of rights re this alleged account was by negotiation, was the alleged account taken for value?
YES NO N/A
46. What is the nature and cause of any value cited in #45 above?
47. If the transfer of rights re this alleged account was by novation, was consent given by alleged Debtor? YES NO N/A
48. What is the nature and cause of any consent cited in #47 above?
49. Has Debt Collector provided alleged Debtor with the requisite verification of the alleged debt as required by the Fair Debt Collection Practices Act? YES NO
50. Date said verification cited above in #49 was provided alleged Debtor:.............................
51. Was said verification cited above in #49 in the form of a sworn or affirmed oath, affidavit, or deposition? YES NO
52. Verification cited above in #49 was provided alleged Debtor in the form of: OATH AFFIDAVIT DEPOSITION.
53. Does Debt Collector have knowledge of any claim(s)/defense(s) re this alleged account? YES NO
54. What is the nature and cause of any claim(s)/defense(s) re this alleged account?
55. Was alleged Debtor sold any products/services by Debt Collector? YES NO
56. What is nature and cause of any products/services cited above in #55?
57. Does there exist a verifiable, bona fide, original commercial instrument between Debt Collector and alleged Debtor containing alleged Debtor’s bona fide signature? YES NO
58. What is the nature and cause of any verifiable commercial instrument cited above in #57?
59. Does there exist verifiable evidence of an exchange of a benefit or detriment between Debt Collector and alleged Debtor? YES NO
60. What is the nature and cause of this evidence of an exchange of a benefit or detriment as cited above in #59?
61. Does any evidence exist of verifiable external act(s) giving the objective semblance of agreement between Debt Collector and alleged Debtor? YES NO
62. What is the nature and cause of any external act(s) giving the objective semblance of agreement from #61 above?
63. Have any charge-offs been made by any creditor or debt collector regarding this alleged account? YES NO
64. Have any insurance claims been made by any creditor or debt collector regarding this alleged account? YES NO
65. Have any tax write-offs been made by any creditor or debt collector regarding this allged account? YES NO
66. Have any tax deductions been made by any creditor or debt collector regarding this alleged account? YES NO
67. Have any judgments been obtained by any creditor or debt collector regarding this alleged account? YES NO
68. At the time the alleged original contract was executed, were all parties apprised of the meaning of the terms and conditions of said alleged original contract? YES NO
69. At the time of the alleged original contract was executed, were all parties advised of the importance of consulting a licensed legal professional before executing the alleged contract? YES NO
70. At the time the alleged original contract was executed, were all parties apprised that said alleged contract was a private credit instrument? YES NO
71. Does Debt Collector have bona fide proof that the live-born human known as John Doe is the fiduciary for the non-existent juristic entity known as JOHN DOE? YES NO
72. Did alleged Creditor inform the live-born human known as John Doe that they would be creating a non-existent juristic entity to be known as JOHN DOE in order to permit the creation of new money based upon a monetized signature which was accepted for value? YES NO
73. If “Yes” to 72, how was this information transmitted? VERBAL IN WRITING
II.
Debt Collector’s failure, both intentional and/or otherwise, in
completing/answering fully, truthfully, and completely questions “1” through
“73”, as enumerated above and returning this Debt Collector Disclosure
Statement, as well as providing Respondent with the requisite verification
validating the hereinabove-referenced alleged debt, within 30 days of its
receipt constitutes Debt Collector’s tacit agreement that Debt Collector has
no verifiable, lawful, bona fide claim re the hereinabove-referenced alleged
account, and that Debt Collector tacitly agrees that Debt Collecter waives all
claims against Respondent and indemnifies and holds Respondent harmless against
any and all costs and fees heretofore and hereafter incurred and related re any
and all collection attempts involving the hereinabove-referenced alleged
account.
III. Declaration: The Undersigned hereby declares under penalty of perjury of the laws of this State that the statements made in this Debt Collector Disclosure Statement are true and correct in accordance with the Undersigned’s best firsthand knowledge.
_______________________________ _____________________________________
Date Printed name of Signatory
_______________________________ ______________________________________
Official Title of Signatory Authorized Signature for Debt Collector
IV.
Debt Collector must timely complete and return this Debt Collector
Disclosure Statement, along with all required documents referenced in said Debt
Collector Statement. Debt
Collector’s claim will not be considered if any portion of the Debt Collector
Disclosure Statement is not completed and timely returned with all required
documents, which specifically includes the requisite verification, made in
accordance with law and codified in the Fair Debt Collection Practices Act
at 15 USC §1692 et seq., and 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,” all of which are violations of law.
If Debt Collector does not respond as required by law, Debt Collector’s
claim will not be considered and Debt Collector may be liable for damages for
any continued collection efforts, as well as any other injury sustained by
Respondent. Please allow thirty
(30) days for processing after Respondent’s receipt of Debt Collector’s
response.
CERTIFICATE OF SERVICE
I hereby certify that I have mailed a copy of the foregoing Request for Verification of Debt, this __________ day of __________, 2003, by U.S. Certified Mail Return Receipt Requested, to __________ _______________ Receipt no.______________________________________
____________________________________
Signature