SAMPLE DOCUMENT INSTRUCTIONS

Declaration of Land Recording and Sovereign Declaration of Status

MEMORANDUM OF LAW WITH POINTS AND AUTHORITIES DECLARATION OF STATUS: REPUDIATION
AND REVOCATION OF THE GOVERNMENT OF YOUR NATION / COUNTRY OF CITIZENSHIP IN ALL
CAPS CORPORATION CITIZENSHIP

NOTICE-TO-AGENT-IS-NOTICE-TO-PRINCIPAL; NOTICE-TO-PRINCIPAL-IS-NOTICE-TO-AGENT

To Whom these presents shall come

LET IT BE NOTED, RECORDED AND KNOWN, to all the living and the dead, and to all those administering
the affairs of the living and the dead, that:

This document is a living testimony; it is my statement of truth, assertion and declaration of status, repudiation,
and revocation of all assumed or implied statutory or commercial obligations along with extant corporate
CITIZENSHIP. I, a Living woman and wish to return to the original land and soil.

When in the course of human events, it becomes necessary for one people to dissolve the political bands
which have connected them with another, and to assume, among the powers of the earth, the separate and
equal station to which the Laws of Nature and of Divine Law.

Lawful Name of declarant; Your Full Name Hereinafter known as the declarant) a living woman the above-
named declarant hereby acknowledges and declare my lawful status to uphold, affirm and abide by the above
stated declaration and confirm that I Am autographing this document.

I declare under penalty of perjury under the true highest Public Law of Your Nation, that I reject, renounce
nullify, void and revoke any/all power of attorney granted by me or under my name or on my behalf by proxy
by any/all others prior to this day. All extant indentures, contracts and proprietorships are hereby rescinded.
By the presentment of this Declaration, I a living woman or women establish my complete authority,
unalienable rights under the highest law in original jurisdiction and revoke consent for any third party to
administer my affairs, properties, or presume to act on my behalf;

I establish that I am the owner and operator of my body, vessels and persons on Earth from the moment my
zygote first formed, together with all DNA and all substance matter in any way associated with me and my
incarnation, and I further declare that I accept my divine origin and all honour, right, title, and material
interests I am owed. With immediate effect all titles are subsumed.

I, Lawful Name of declarant; Your Full Name Born on the Your Born Day day of Born Month in the year of
Born Year hereby confirm that I uphold the principles of universal law and assert all my Unalienable rights.

I exert my lawful standing within the jurisdiction of the land on earth known as (Addendum Reference) Enter
Name of Land, Your Nation. I am a lawful inhabitant of the land and a natural born lawful naturalized
member of the population of this country.

As a living sovereign individual I have the ability to choose, that capability to contract and the will to record
my political status in original jurisdiction.

I hereby establish my permanent home in care of address at; Your Full Address and no other presumption or

[543.1.1] Page 1 of 2
impersonation is allowed.
I claim all my rights as the naked owner and the original entitlement holder in due course of all associated
names, persons, patents, properties and assets. I take full responsibility for my actions, liabilities, and
decisions.

I declare under the aforementioned penalties that I am a Lawful Inheritor, Landlord, Keeper, and Guardian of
the Rightful and Lawful Government of this country, acting with Full Right, Authority, Responsibility and
Honour, now and always while my tenure on Earth shall last — and I present this Declaration and place it
upon the Public Record of Your Assembly or Place of Public Record
___________________________________

This Declaration is valid, true, correct, and complete in all jurisdictions of law: air, land, and sea. So signed
and sealed IN WITNESS WHEREOF, autographed at __________________________________

___________________________________ on the _______ day of _____________________ in the year 2023.

By Your Full Name © Autograph
All Rights Reserved

(Instructions: If your last name is different than your birth name, add (nee’ birth last name) both printed
and autographed. Example: Mary Jane Smith (nee’ Jones)
Your Full Name © Printed
Declarant [print] [autograph]

Your Full Address

c/o ______________________________________________________________________________________

__________________________________________ __________________________________________
Witness [autograph] Witness [autograph]

Jurat
Before me, the undersigned Land Recording Secretary and Commissioner for Oaths, appeared the living
woman Your Full Name known to me to be the one whose name is subscribed above, and acknowledged
execution of the same for the purposes therein contained.

Witness my hand and official seal this _______ day of _________________, 2023.

__________________________________________
NOTARY/COMMISSIONER FOR OATHS AND LAND RECORDING SECRETARY

The Global Family Group LRPS

Universal Land Record Form Instructions
v1.11-23-22 [04-07-23]

[543.1.1] Page 2 of 2
Declaration of Land Recording and Sovereign Declaration of Status
MEMORANDUM OF LAW WITH POINTS AND AUTHORITIES DECLARATION OF STATUS:
REPUDIATION AND REVOCATION OF THE GOVERNMENT OF ____________________________________
CORPORATION CITIZENSHIP

NOTICE-TO-AGENT-IS-NOTICE-TO-PRINCIPAL; NOTICE-TO-PRINCIPAL-IS-NOTICE-TO-AGENT

To Whom these presents shall come

LET IT BE NOTED, RECORDED AND KNOWN, to all the living and the dead, and to all those administering
the affairs of the living and the dead, that:

This document is a living testimony; it is my statement of truth, assertion and declaration of status,
repudiation, and revocation of all assumed or implied statutory or commercial obligations along with
extant corporate CITIZENSHIP. I, a Living woman express intent to declare my sovereign political
status and assert all Unalienable rights under the highest law and wish to return to the original land and
soil.

When in the course of human events, it becomes necessary for one people to dissolve the political bands
which have connected them with another, and to assume, among the powers of the earth, the separate and
equal station to which the Laws of Nature and of Divine Law.

Lawful Name of declarant; ____________________________ (Hereinafter known as the declarant) a living

woman — the above-named declarant hereby acknowledges and declare my lawful status to uphold, affirm
and abide by the above stated declaration and confirm that I Am autographing this document.

I declare under penalty of perjury under the true highest Public Law of __________________________ that I
reject, renounce nullify, void and revoke any/all power of attorney granted by me or under my name or on
my behalf by proxy by any/all others prior to this day. All extant indentures, contracts and proprietorships
are hereby rescinded. By the presentment of this Declaration, I a living woman establish my complete
authority, unalienable rights under the highest law in original jurisdiction and revoke consent for any
third party to administer my affairs, properties, or presume to act on my behalf;

I establish that I am the owner and operator of my body, vessels and persons on Earth from the moment my
zygote first formed, together with all DNA and all substance matter in any way associated with me and my
incarnation, and I further declare that I accept my divine origin and all honour, right, title, and material
interests I am owed. With immediate effect all titles are subsumed.

I, Lawful Name of declarant ; ________________________ Born on the ____ day of _______________ in the
year of _______ hereby confirm that I uphold the principles of universal law and assert all my Unalienable
rights.

I exert my lawful standing within the jurisdiction of the land on earth known as (Addendum Reference)
______________________. I am a lawful inhabitant of the land and a natural born lawful naturalized member
of the population of this country.

As a living sovereign individual I have the ability to choose, that capability to contract and the will to record
my political status in original jurisdiction.
[543.1.1] Page 1 of 2
I hereby establish my permanent home in care of address at; __________________________________________
and no other presumption or impersonation is allowed.

I claim all my rights as the naked owner and the original entitlement holder in due course of all associated
names, persons, patents, properties and assets. I take full responsibility for my actions, liabilities, and
decisions.

I declare under the aforementioned penalties that I am a Lawful Inheritor, Landlord, Keeper, and Guardian of
the Rightful and Lawful Government of this country, acting with Full Right, Authority, Responsibility and
Honour, now and always while my tenure on Earth shall last — and I present this Declaration and place it
upon the Public Record of ___________________________________

This Declaration is valid, true, correct, and complete in all jurisdictions of law: air, land, and sea. So signed
and sealed IN WITNESS WHEREOF, autographed at ___________________________________

___________________________________ on the _______ day of _____________________ in the year 2023.

By __________________________________________
All Rights Reserved

__________________________________________
Declarant [print] [autograph]

c/o______________________________________________________________________________________

__________________________________________ __________________________________________
Witness [autograph] Witness [autograph]

Jurat
Before me, the undersigned Land Recording Secretary and Commissioner for Oaths, appeared the living
woman ___________________________ known to me to be the one whose name is subscribed above, and
acknowledged execution of the same for the purposes therein contained.

Witness my hand and official seal this _______ day of _________________, 2023.

__________________________________________
NOTARY/COMMISSIONER FOR OATHS AND LAND RECORDING SECRETARY

The Global Family Group LRPS

Universal Land Record Form
v1.11-23-22 [04-07-23]

[543.1.1] Page 2 of 2