county of ___________________ )

) ss:

North-Carolina American Republic )

KNOW ALL MEN BY THESE PRESENTS: I,_____________________________________________,

Sui Juris, having first-hand knowledge of the facts as stated herein, hereinafter “affiant”, do hereby declare my proper and lawful status with respect to Citizenship and Domicile, to-wit:

1. Your affiant’s natural birth occurred in ________________________________________________state, on the ________________________ day of ________________________________, 19 _________.

2. Your affiant has been an Inhabitant of North-Carolina from ____________________________, 19 ______ until the present.

3. Your affiant clearly understands the difference between a “state Citizen” and a “United States citizen; your affiant is not a federal “U.S. citizen”.

(a) “We have in our political system, a government of each of the several states and a government of the United States. Each is distinct from the other and has citizens of its own.” U.S. v. Cruikshank , 92 US 542.

(b) “The persons declared to be citizens are ‘..all persons born or naturalized in the United States and subject to the jurisdiction thereof.’ The evident meaning of these last words is, not merely subject in some respect or degree to the jurisdiction of the United States, but completely subject.” Elk v. Wilkins , 112 US 94.

(c) “The privileges and immunities clause of the 14 th Amendment protects very few rights because it neither incorporates the Bill of Rights nor protects all rights of individual citizens. Instead this provision protects only those rights peculiar to being a citizen of the federal government. It does not protect those rights which belong to state Citizenship .” Jones v. Temmer , 829 F. Supp. 1226 (1993).

4. Your affiant clearly understands that the term “United States” has three different meanings, and must be defined with respect to issues of law and citizenship;

(a) “The term ‘United States’ may be used in any one of the following senses: (1) It may merely be the name of a sovereign occupying the position analogous to that of other sovereigns in the family of nations or, (2) It may designate the territory over which the United States is sovereign or, (3) It may be the collective names of the several states which are united by and under the Constitution.” Hooven & Allison v. Evatt , 324 US 652 (definitions hereinafter referred to as “ 1 st Hooven, 2 nd Hooven, etc. )

(b) “A person is born subject to the jurisdiction of the United States, for purposes of acquiring citizenship at birth, if this birth occurs in a territory over which the United States is sovereign” [ 2 nd Hooven ]. 3 Am. Jur. 1420.

(c) “The United States government is a foreign corporation with respect to a state. NY in re Merriam , 41 Led 287.

5. Your affiant is not a person subject to the exclusive jurisdiction of Congress as defined in Article I, Section 8 (17) of the United States Constitution and any claimed allegiance to the United States ( 2 nd Hooven ) is hereby renounced. Your affiant is an American, but not a 14 th Amendment U.S. citizen.

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6. Your affiant has become aware of 8 U.S.C.A. §§ 1481 & 1483, and has noticed that the terms “United States citizen” and “American citizen” appear to be used interchangeably in the notes, however, as the above case law clearly demonstrates, there has been established a clear distinction between the two terms. (“U.S. citizen” referring to 2 nd Hooven and “American referring to 1 st and 3 rd Hooven definitions.)

7. Any and all contracts or agreements which would tend to indicate that your affiant is a ‘U.S. citizen”; a citizen of the federal government, are hereby declared to be null and void. Your affiant hereby declares that any such contract/agreement was not entered into knowingly, voluntarily and intentionally, and therefore was the result of Constructive Fraud (Black’s Law Dictionary 6 th Ed. p. 314).

8. Your affiant has never volunteered into the Social Security system nor obtained a “S.S.” number. Any such “identifying number” assigned by someone else belongs to them and is null and void with respect to your affiant. Your affiant does not and will not use any such identifying number assigned by any entity.

9. Through a study of history, your affiant has discovered that the de jure state of North-Carolina was laid dormant as of the 1 st of the “Reconstruction Acts” on 2 March 1867, and that a new “constitution” was forced upon her in 1868, completing the forced creation of a federal district known as the State of North Carolina, in direct contravention of the July 1861 Resolutions of the United States House and Senate.

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10. However, the de jure state of North-Carolina existed as a republic prior to the formation of the United States ( 1 st Hooven ) and, as Article IV, Section 4 of the Constitution for the United States of America guarantees to each state a republican form of government, your affiant does not recognize the de facto State of North Carolina as a de jure, sovereign state. Said State is a de facto corporation, allowing only 14 th Amendment U.S. citizens to vote and hold office therein.

11. Your affiant hereby declares that any and all contracts or agreements which may be claimed to exist between your affiant and the de facto STATE OF NORTH CAROLINA to be null and void, as any such contract/agreement was not entered into knowingly, voluntarily and intentionally and constitutes constructive fraud.

12. SERVE NOTICE : The de jure state of North-Carolina was re-established on 1 December 1997, of Right, Duty, and of necessity, and by the popular vote of state Inhabitants who were not and are not federal U.S. citizens, returning to the organic state Constitution of 1776. A few Amendments were made to that Constitution, of necessity, and all have “sunset clauses” save one.

13. The one permanent Amendment passed rescinded the secession Ordinance of 20 May 1861, as the Inhabitants of the de jure republic do not wish to secede from the United States of America ( 3 rd Hooven ), rather, to re-establish the antebellum status of the state of North-Carolina in which the Inhabitants are neither a conquered or a subjugated people, and where their Rights are both guaranteed and protected.

14. Pursuant to 8 U.S.C.A. §§1481 & 1483, your affiant has, and hereby does, knowingly, voluntarily and intentionally:

(a) Make a formal declaration of allegiance to North-Carolina, a state foreign to the United States ( 2 nd Hooven ), and paid taxes therein, thereby securing the right to vote in that state;

(b) Decline and reject dual citizenship (state/Federal);

(c) Declare that your affiant is not a “ resident of ”, an “ inhabitant of ” or “ domiciled within ” the United States ( 2 nd Hooven );

(d) Enter into a covenant (common-law contract) with a state foreign to the United States ( 2 nd Hooven ) for the protection of rights and property and;

(e) Declare that your affiant is a North-Carolina state Citizen and not a “U.S.” federal citizen.

15. Your affiant hereby reserves all of his/her common-law rights to not be compelled to perform under any contract/agreement which your affiant did not enter into knowingly, voluntarily and intentionally, and further-more, your affiant does not accept the liability associated with the compelled benefit of any unrevealed contract or commercial agreement.

WHEREFORE : Your affiant further saith naught.

NOTE: This affidavit is not intended for national expatriation, it is intended for renunciation of domestic Federal citizenship and claim to exclusive lawful state citizenship.

This Affidavit is in compliance with Article 40, Constitution of North-Carolina-1776 as amended.

SIGNED: __________________________________ on this the _______________ day of _________________________ 200____

Affiant

W e did witness the affiant’s voluntary signature: Deuteronomy 19:15 On the evidence of 2 or 3 witnesses a matter shall be confirmed.

_______________________________ / _____________________________________ / ________________________________

First Witness Second Witness Third Witness

North-Carolina tax paid : _________ Dollars in silver coin of the United States of America, ____________

Date

Received by: _____________________________________ , title __________________________________

S ealed unto my hand this the ________________ day of ______________________ 200___,

Authorized signature ____________________________

title___________________________ SEAL

Notice: Original signatures to be in blue ink

Form # 98ACD(b), ( Affidavit of citizenship and domicile) 1/21/00

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