Friday, February 5, 2010

$1,348.71US Statement of Debt Owed By Henry W. Hochstatter Incurred During December 2008, 2009, 2010

For the record, I, Henry W. Hochstatter, owe $1,348.71US, one thousand three hundred and forty-eight dollars and seventy-one cents in U.S. dollars to Gardenia C. Hung for the credit usage of the Chase credit card during December 2008 through 2009 and 2010. I asked Gardenia C. Hung to charge the Chase credit card for lodging residential expenses, gasoline, and other miscellaneous expenses at InTown Residential Suites in Villa Park, Illinois during December 31, 2008 and from January 1st, 2009 through November 17, 2009, plus other expenses during 2010.

Verification

Under penalties as provided by law, pursuant to Section 1-109 of the Illinois Code of Civil Procedure, the undersigned certifies that the statement set forth in this instrument are true and correct, to the best of my ability, so help me God.


Signed by Henry W. Hochstatter (Reserved)

Executed in the Village of Villa Park, County of DuPage, in the State of Illinois, United States of America.