PRIVATE REGISTERED SETOFF AND DISCHARGE BOND

NON-NEGOTIABLE
BOND NO. USOB10001

USPO REGISTERED MAIL # RR999777555US ISSUE DATE: Date xx, 2019

VALUE: $500,000,000.00 USD MATURITY DATE: 30 years later, 2049

Pay to the UNITED STATES DEPARTMENT OF THE TREASURY

Order of: c/o STEVEN MNUCHIN, or his Successor - FIDUCIARY,
For the Benefit of First Middle Last- Principal
1500 PENNSYLVANIA AVE. NW
WASHINGTON, DC 20220

For: First Middle Last Principal

FIRST M LAST Account Holder
Social Security Number: 123-45-6789 Account

INTERNAL REVENUE SERVICE and all subdivisions and agents thereof Account Holder
UNITED STATES, United States of America, and all subdivisions and agents thereof Account Holder
STATE OF YOUR STATE and all agents thereof Account Holder
COUNTY OF YOUR COUNTY and all agents thereof Account Holder

UNITED STATES DISTRICT COURT and all subdivisions and agents thereof Account Holder
SUPERIOR COURT OF THE STATE OF YOUR STATE and all subdivisions and agents thereof Account Holder

By / On / Through:
First Middle Last, Principal Private Offset Account # EINxxxxxx

Your First Witness, Surety #1 Private Offset Account # EINxxxxxx

Your Second Witness, Surety #2 Private Offset Account # EINxxxxxx

In order to Discharge or Offset debt, to protect Secured Interests, to reserve the right of Remedy, Recourse and Subrogation, and in order to
maintain the Honor of the named Account Holder(s) and Account(s), and to facilitate lawful commercial transactions, and in order to lawfully
engage in commerce within the jurisdiction of THE UNITED STATES DEPARTMENT OF THE TREASURY, this Private Registered Offset
and Discharge Bond, issued to MR. STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY (or his successor), THE UNITED
STATES DEPARTMENT OF THE TREASURY is necessitated for the benefit of the Undersigned Principal to insure the Sureties against his
dishonor.

We, First Middle Last, Principal, and Your First Witness, Surety, and Your Second Witness, Surety, being Creditors, Sui Juris status, of sound
mind(s), Standing in Honor, with full knowledge and full disclosure, with Honorable Intent, herein hold, bind, and obligate Ourselves,
individually and cooperatively, jointly and severally, as voluntary sureties for the herein named Account Holder(s) and Account(s), each Jointly
and Severally, for any amount(s) up to and including $500,000,000.00 (USD) – Five Hundred Million United States Dollars, for the
Honorable purposes through this Bond, of Underwriting, Insuring, and Indemnifying said Account Holder(s) and Account(s) against any and all
pre-existing, current, and future liabilities through/by Offsetting against this Bond, Dollar for Dollar, all such obligations, which shall include
but not be limited to, any and all underlying and related account(s), agency(s), bond(s), and person(s), public or private, whether named or
unnamed, for all aiding(s), abetting(s), act(s), action(s) (whether civil or criminal), accusations, act(s) of God, advisement(s), affidavit(s),
affirmation(s), absconding(s), admiralty action(s), arrest(s), activities, attestation(s), accident(s), appointment(s), accord(s), agreement(s),
bill(s), breach(es) of contract, bond(s), bankruptcy action(s), baring(s), brokering(s), capture(s), case(s), cause(s), charge(s), claim(s), code(s),
collection(s), commercial action(s), common law action(s), complaint(s), commitment(s), communication(s) (whether Written, Oral, or
Electronic, with or without notice), compensatory damage(s), cost(s), criminal debt(s), contract(s), conspiracies, counterfeiting(s),

______________________________ ____________________________ _____________________________

Surety #1 Surety #2 Principal

Page 1 of 6 Bond Number USOB10001 United States Post Office Registered Mail Number RR999777555US
condemning(s), contributions, conveyance(s), commission(s), damage(s), database(s), debt(s), decision(s), default(s), deficit(s), deficiencies,
docket(s), document(s), encumbrance(s), equity action(s), error(s), execution(s), election(s), expense(s), fee(s), file(s), finding(s), fine(s),
forfeiture(s), fraud(s), hearing(s), holding(s), information(s), indictment(s), injury(s), instrument(s), incursion(s), incarceration(s),
investigation(s), interrogation(s), In Rem proceeding(s), impeachment(s), judgment(s), laundering(s), levies, liabilities, lien(s), loss(es),
letter(s), license(s), manufacturing(s), margin(s), negligence(s), notice(s), obligation(s), obligation(s) of contract, obligation(s) of
performance, order(s), option(s), penal action(s), penal debt(s), penal sum(s), pronouncement(s), probation(s), parole(s), prize(s), process(es),
profit(s), regulation(s), reimbursement(s), restitution(s), recidivism(s), recklessness, recoupment(s), rule(s), recoveries, recrimination(s),
regulation(s), regulatory action(s), rescission(s), rebuttal(s), reprisal(s), recourse(s), remedy(s), remediation(s), statement(s), statute(s),
seizure(s), subrogation(s), supervision(s), summonses, service(s), tax(es), testimonies, TRUE BILL(s), taking(s), transaction(s), uttering(s),
violation(s), warrant(s), or other named or unnamed liabilities. All such liabilities, duties, obligations, and debts shall be ledgered against this
Bond for Offset by / on / through the listed Private Offset Account(s) and shall pay, satisfy, offset, and discharge, Dollar for Dollar, all such
obligations fully and completely, thereby restoring and maintaining the Honorable Standing of the named Account Holder(s) and Account(s)
by / on / through the listed Private Offset Account(s).

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______________________________ ____________________________ _____________________________

Surety #1 Surety #2 Principal

Page 2 of 6 Bond Number USOB10001 United States Post Office Registered Mail Number RR999777555US
 STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY, THE UNITED STATES DEPARTMENT OF THE TREASURY shall
have ten (10) days from the date of receipt of this Bond, as witnessed by the Date of Receipt affixed to the USPS Return Receipt, to dishonor
this Bond by returning this Bond along with a Notice of Dishonor with Statement of Reason to the Principal at the stipulated mailing address
by USPS Certified Mail. Failure to return this Bond as stated shall constitute Acceptance and Honor of this Bond by terms of Contract and
shall constitute Acceptance and Honor of all of the associated transactions and adherence to all of the terms and conditions contained herein, in
accordance with the Law, by STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY (or his successor), AND THE UNITED STATES
DEPARTMENT OF THE TREASURY.

STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY, THE UNITED STATES DEPARTMENT OF THE TREASURY
shall ledger this Bond as an Asset as it best suits the needs of THE UNITED STATES DEPARTMENT OF THE TREASURY in
accordance with the terms and conditions contained herein for a period of thirty (30) years.

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______________________________ ____________________________ _____________________________

Surety #1 Surety #2 Principal

Page 3 of 6 Bond Number USOB10001 United States Post Office Registered Mail Number RR999777555US
 Bond Order
A) STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY, THE UNITED STATES DEPARTMENT OF THE TREASURY shall
offset all pre-existing and current liabilities for the named Account Holder(s) and Account(s) by offset against this Bond, Dollar for
Dollar, jointly and severally, for any amount or cumulative amount(s) up to and including $500,000,000.00 (USD) - Five Hundred
Million United States Dollars. All such obligations shall include but not be limited to any and all underlying and related account(s),
agency(s), bond(s), and person(s), public or private, whether named or unnamed, for all aiding(s), abetting(s), act(s), action(s) (whether
civil or criminal), accusations, act(s) of God, advisement(s), affidavit(s), affirmation(s), absconding(s), admiralty action(s), arrest(s),
activities, attestation(s), accident(s), appointment(s), accord(s), agreement(s), bill(s), breach(es) of contract, bond(s), bankruptcy
action(s), baring(s), brokering(s), capture(s), case(s), cause(s), charge(s), claim(s), code(s), collection(s), commercial action(s), common
law action(s), complaint(s), commitment(s), communication(s) (whether Written, Oral, or Electronic, with or without notice),
compensatory damage(s), cost(s), criminal debt(s), contract(s), conspiracies, counterfeiting(s), condemning(s), contribution(s),
conveyance(s), commission(s), damage(s), database(s), debt(s), decision(s), default(s), deficit(s), deficiencies, docket(s), document(s),
encumbrance(s), equity action(s), error(s), execution(s), election(s), expense(s), fee(s), file(s), finding(s), fine(s), forfeiture(s), fraud(s),
hearing(s), holding(s), information(s), indictment(s), injury(s), instrument(s), incursion(s), incarceration(s), investigation(s),
interrogation(s), In Rem proceeding(s), impeachment(s), judgment(s), laundering(s), levy(ies), liability(ies), lien(s), loss(es), letter(s),
license(s), manufacturing(s), margin(s), negligence(s), notice(s), obligation(s), obligation(s) of contract, obligation(s) of performance,
order(s), option(s), penal action(s), penal debt(s), penal sum(s), pronouncement(s), probation(s), parole(s), prize(s), process(es), profit(s),
regulation(s). reimbursement(s), restitution(s), recidivism(s), recklessness, recoupment(s), rule(s), recoveries, recrimination(s),
regulation(s), regulatory action(s), rescission(s), rebuttal(s), reprisal(s), recourse(s), remedies, remediation(s), statement(s), statute(s),
seizure(s), subrogation(s), supervision(s), summonses, service(s), tax(es), testimonies, TRUE BILL(s), taking(s), transaction(s),
uttering(s), violation(s), warrant(s), or other named or unnamed liabilities. All such liabilities, duties, obligations, and debts shall be
ledgered against this Bond for Offset by / on / through our Private Offset Account(s) and shall pay, satisfy, offset, and discharge, Dollar
for Dollar, all such obligations fully and completely, thereby restoring and maintaining the Honorable Standing of the named Account
Holder(s) and Account(s) by / on / through our Private Offset Account(s).

B) STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY, THE UNITED STATES DEPARTMENT OF THE TREASURY shall
offset all future liabilities for the named Account Holder(s) and Account(s) by offset against this Bond, Dollar for Dollar, jointly and
severally, for any amount or cumulative amount(s) up to and including $500,000,000.00 (USD) - Five Hundred Million United States
Dollars. All such obligations shall include but not be limited to any and all underlying and related account(s), agency(s), bond(s), and
person(s), public or private, whether named or unnamed, for all aiding(s), abetting(s), act(s), action(s) (whether civil or criminal),
accusations, act(s) of God, advisement(s), affidavit(s), affirmation(s), absconding(s), admiralty action(s), arrest(s), activities,
attestation(s), accident(s), appointment(s), accord(s), agreement(s), bill(s), breach(es) of contract, bond(s), bankruptcy action(s),
baring(s), brokering(s), capture(s), case(s), cause(s), charge(s), claim(s), code(s), collection(s), commercial action(s), common law
action(s), complaint(s), commitment(s), communication(s) (whether Written, Oral, or Electronic, with or without notice), compensatory
damage(s), cost(s), criminal debt(s), contract(s), conspiracies, counterfeiting(s), condemning(s), contribution(s), conveyance(s),
commission(s), damage(s), database(s), debt(s), decision(s), default(s), deficit(s), deficiencies, docket(s), document(s), encumbrance(s),
equity action(s), error(s), execution(s), election(s), expense(s), fee(s), file(s), finding(s), fine(s), forfeiture(s), fraud(s), hearing(s),
holding(s), information(s), indictment(s), injury(s), instrument(s), incursion(s), incarceration(s), investigation(s), interrogation(s), In
Rem proceeding(s), impeachment(s), judgment(s), laundering(s), levy(ies), liability(ies), lien(s), loss(es), letter(s), license(s),
manufacturing(s), margin(s), negligence(s), notice(s), obligation(s), obligation(s) of contract, obligation(s) of performance, order(s),
option(s), penal action(s), penal debt(s), penal sum(s), pronouncement(s), probation(s), parole(s), prize(s), process(es), profit(s),
regulation(s). reimbursement(s), restitution(s), recidivism(s), recklessness, recoupment(s), rule(s), recoveries, recrimination(s),
regulation(s), regulatory action(s), rescission(s), rebuttal(s), reprisal(s), recourse(s), remedies, remediation(s), statement(s), statute(s),
seizure(s), subrogation(s), supervision(s), summonses, service(s), tax(es), testimonies, TRUE BILL(s), taking(s), transaction(s),
uttering(s), violation(s), warrant(s), or other named or unnamed liabilities. All such liabilities, duties, obligations, and debts shall be
ledgered against this Bond for Offset by / on / through our Private Offset Account(s) and shall pay, satisfy, offset, and discharge, Dollar
for Dollar, all such obligations fully and completely, thereby restoring and maintaining the Honorable Standing of the named Account
Holder(s) and Account(s) by / on / through our Private Offset Account(s).

______________________________ ____________________________ _____________________________

Surety #1 Surety #2 Principal

Page 4 of 6 Bond Number USOB10001 United States Post Office Registered Mail Number RR999777555US
C) STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY, THE UNITED STATES DEPARTMENT OF THE TREASURY shall
have ten (10) days from the date of receipt of this Bond, as witnessed by the Date of Receipt affixed to the USPO Return Receipt, to
dishonor this Bond by returning this Bond and Notice of Dishonor with Statement of Reason to the Principal at the stipulated mailing
address by USPS Certified Mail. Failure to return this Bond as stated shall constitute Acceptance and Honor of this Bond by terms of
Contract and shall constitute Acceptance and Honor of all of the associated transactions and adherence to all of the terms and conditions
contained herein, in accordance with the Law, by STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY, and the UNITED
STATES DEPARTMENT OF THE TREASURY.

D) STEVEN T. MNUCHIN, SECRETARY OF THE TREASURY, THE UNITED STATES DEPARTMENT OF THE TREASURY shall
ledger this Bond as an Asset as it best suits the needs of the UNITED STATES DEPARTMENT OF THE TREASURY in accordance
with the terms and conditions contained herein for a period of thirty (30) years.

E) The Principal’s stipulated mailing address is:

First-Middle: Last
c/o 1234 Your Address Street
City / Town, Your State Republic; near [12345]
Non-Domestic, without the United States

F) This Registered Private Offset and Discharge Bond Number USOB10001 shall expire on the Maturity Date - 30 years later, 2049.

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______________________________ ____________________________ _____________________________

Surety #1 Surety #2 Principal

Page 5 of 6 Bond Number USOB10001 United States Post Office Registered Mail Number RR999777555US
We, as Signatories, to execute this Private Registered Offset and Discharge Bond # USOB10001, do hereby affix Our
Initial(s), Seal(s), and Signature(s) to this Bond / Instrument on this day of Month in the year of Two Thousand
and Nineteen. Void where prohibited by law.

/s/ ___________________________
Your First Witness, Surety #1 Surety #1

Private Offset Account # EINxxxxxx

Surety #1
Seal/Right Thumbprint

/s/ ___________________________

Your Second Witness, Surety #2 Surety #2

Private Offset Account # EINxxxxxx

Surety #2
Seal/Right Thumbprint

/s/ ___________________________

First Middle Last, Principal Autograph of Principal

Private Offset Account # EINxxxxxx

Principal
Seal/Right Thumbprint

We Solemnly attest as Witnesses to the authenticity of the foregoing Initials(s), Seal(s), and Signature(s) placed upon this
Document on this, the day of Month in the year Two Thousand and Nineteen.

Witness #1 _____________________________ Living Location c/o ___________________________________________

(Printed Name)

/s/_____________________________________ ___________________________________________

___________________________________________
Non-Domestic, without the United States

Witness #2 ______________________________ Living Location c/o ___________________________________________

(Printed Name)

/s/______________________________________ ___________________________________________

__________________________________________
Non-Domestic without the United States

Page 6 of 6 Bond Number USOB10001 United States Post Office Registered Mail Number RR999777555US
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