This Contract Is Made This ________ day of _______________,20____ By And Between:

_________________________________________

and

_________________________________________

I, _________________________________________ agree to process all paper work that is necessary for the release $___________

that is owed to ______________________. Upon payment of $_____________

I _________________________________________, agree to immediately disclose information and the documents explaining the funds.

I _________________________________________, also agree to immediately process all paper work necessary for the release of the funds directly to

_________________________________________ . The exact amount of the refund is $________.

That's ______________________________ And /100 Dollars.

I _________________________________________, agree to pay _________________________________________ for their services, providing that their services do indeed result in a payment to me in the amount stated above.

I understand that it may or may not take as long as 120 days to receive my United States Treasury Check.

If for any reason _________________________________________ does not follow through in processing the paper work necessary for the release of the funds, _________________________________________ agrees to pay back all monies received immediately.