Download - Affidavit of Original Issue (2)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
[Change all items in blue below, delete red notes, then change all print to black before printing.]
IN THE MUNICIPAL COURT OF THE STATE OF CALIFORNIA
FOR THE COUNTY OF ORANGE
STATE OF CALIFORNIA,
Plaintiff,
v.
JOHN H. DOE©,
Alleged Defendant.
Case No. 0108-XXXX
AFFIDAVIT OF ORIGINAL ISSUE;
NOTICE OF ALLEGED DEFENDANT'S ACCEPTANCE OF CLAIM;
NOTICE OF COURT'S ABANDONMENT OF CLAIM;
MOTION AND ORDER TO DISMISS
[Change all to the particulars of your case,
i.e., the plaintiff, defendant, and your
document name, case number, etc.]
State of CALIFORNIA ) ) ss.County of ORANGE )
SWORN AFFIDAVIT OF FACT
I, John Henry, family of Doe, the Undersigned Affiant, hereinafter "Affiant," does hereby
solemnly swear (or affirm), declare, and state as follows:
1. Affiant is competent to state the matters set forth herewith.
2. Affiant has personal first-hand knowledge of the facts stated herein.
3. All the facts stated herein are true, correct, and complete in accordance with Affiant's
best firsthand knowledge and understanding, and if called upon to testify as a witness
Affiant shall so state.
Page 1 of 4 – AFFIDAVIT OF ORIGINAL ISSUE; NOTICE; MOTION AND ORDER TO DISMISS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Plain Statement of Facts
4. Affiant is the agent for alleged Defendant JOHN H. DOE©.
5. Alleged Defendant JOHN H. DOE© is the "Original Issuer" of the credit on the debt
instrument commonly known and identified as Claim or Case No. 0108-XXXX in
THE MUNICIPAL COURT OF THE STATE OF CALIFORNIA FOR THE
COUNTY OF ORANGE.
6. THE MUNICIPAL COURT OF THE STATE OF CALIFORNIA FOR THE
COUNTY OF ORANGE is a corporation doing business under an unknown tax
identification number also known as THE EAST OCEANSIDE MUNICIPAL
COURT OF THE STATE OF CALIFORNIA located at 1234 River Avenue,
OCEANSIDE, CA 86851.
7. The Original Issue price of $20,289.92 for Claim or Case No. 0108-XXXX was
accepted on June 30, 2008, by THE MUNICIPAL COURT OF THE STATE OF
CALIFORNIA FOR THE COUNTY OF ORANGE and is filed on Internal Revenue
Service Form 1099-OID (attached hereto and stated herein as alleged Defendant's
"Exhibit A").
8. Creditor JOHN H. DOE© accepted the Claim or Case No. 0108-XXXX on the
attached Internal Revenue Service Form 1099-OID (please see "Exhibit A") for the
assessed value of the taxes owed.
9. There being no controversy in THE EAST OCEANSIDE MUNICIPAL COURT OF
THE STATE OF CALIFORNIA on Claim or Case No. 0108-XXXX, this court does
Page 2 of 4 – AFFIDAVIT OF ORIGINAL ISSUE; NOTICE; MOTION AND ORDER TO DISMISS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
not have subject matter jurisdiction and must vacate any order(s) or judgment(s)
made.
10. THE EAST OCEANSIDE MUNICIPAL COURT FOR THE STATE OF
CALIFORNIA has abandoned the claim (attached hereto and stated herein as alleged
Defendants "Exhibit B").
11. THE EAST OCEANSIDE MUNICIPAL COURT FOR THE STATE OF
CALIFORNIA is in receipt of the proper Internal Revenue Service Forms 1099-OID
and 1099-A (attached hereto and stated herein as alleged Defendant's "Exhibits A &
B") for the abandonment of the Tax in this Claim or Case No. 0108-XXXX.
12. THE EAST OCEANSIDE MUNICIPAL COURT FOR THE STATE OF
CALIFORNIA, a corporation doing business under an unknown tax identification
number located at 1234 River Avenue, OCEANSIDE, CA 86851, is in violation of
United States Code Title 26 for Tax Fraud.
Wherefore the undersigned hereby moves the Court to dismiss the Plaintiff’s
complaint of June 30, 2008 . The undersigned is not a lawyer.
Dated this ______ day of _________________, 2008.
JOHN H. DOE©, alleged Defendant
By: John Henry, Agent John Henry, family of Doe, a living being
Principal, Sovereign, Power of Attorney-in-FactNo liability assumed Always with all God-given rights, waiving none ever
Page 3 of 4 – AFFIDAVIT OF ORIGINAL ISSUE; NOTICE; MOTION AND ORDER TO DISMISS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
JURAT
County of ORANGE ) ) ss.State of CALIFORNIA )
Signed and sworn to (or affirmed) before me on this, the ______ day of June, A.D. 2008,
by John Henry, family of Doe. WITNESS my hand and official seal:
___________________________________________Notary for the State of CALIFORNIAMy commission expires: ____________________
ORDER
IT IS HEREBY ORDERED that the above captioned case, and the Complaint of the
Plaintiff be dismissed with prejudice and any Notice(s) of Lis Pendens be removed from record.
Dated: _____________________, 2008.
__________________________________________Presiding Judge
Page 4 of 4 – AFFIDAVIT OF ORIGINAL ISSUE; NOTICE; MOTION AND ORDER TO DISMISS