Revocation of ALL Underwritings
by [PEO],
An American Principal Executive Officer.



This document contains

• this instruction page
• [faxcount] Fax pages

• Attachment with Social Security card.

1. Print this file in color on good quality paper.
2. Sign the Faxes and Attachment as PEO (Mr. John-Joseph; Smith:)
3. Put a 3¢ stamp in the lower right hand corner of the Faxes and Attachment. Place a red thumb print touching the bottom of the stamp.
4. Emboss your signatures and stamps and highlight the embossing with ink if possible.
5. Enter the date at the bottom of each page.
6. Scan the signed Faxes and Attachment to separate PDF files.
7. Keep the signed originals for your files.
8. Print the [faxcount] scanned signed Faxes in color.
9. Print [faxcount] copies of the Attachment in color, one for each fax.

10. Send each Fax and an Attachment to whom it is addressed.
11. If you do not have a fax machine, use http://faxzero.com to send the scanned Fax and Attachment. You can send up to 5 3-page faxes per day for free.
12. Otherwise you can sign up for http://metrofax.com for $8/mo. Youcan send 150 pages/mo and extra pages at 3¢/page. Sign up for a free fax number to receive faxes at http://efax.com.

13. Mail each Fax and an Attachment to whom it is addressed.
14. You can print the addresses on the next on label stock or cut and paste them onto envelopes.

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Addresses

[ADDRESSES] [PAGEBREAK]