AFFIDAVIT

OF
BIRTH CERTIFICATE
BENEFICIAL OWNERSHIP

One, Last: First-Middle, private man/woman, not an entity, national of the United States of
America, the Executor/beneficiary for the Estate Trust of FIRST MIDDLE LAST a Public
Register State Agency, by the powers vested in trust, hereby certify that I am familiar with the
facts recited below; and that;

1. The Executor is a beneficiary of the age of majority; and that;

2. The party named in said Birth Certificate attached, not official just certified copy, and
made part hereof, is the same party as the Authenticated Register Beneficiary/Executor named in
this Affidavit:

FIRST MIDDLE LAST a Public Register State Agency, Estate, held in Trust,
Birth Certificate No. XXX-XX-XXXXXX, registered in STATE OF (YOUR STATE),
DEPARTMENT OF HEALTH, DIVISION OF VITAL STATISTICS with State Registrar
in (your City, State); and that;

3. The Executor is using this Affidavit to document the status of a superior lien over the
principle, interest, and all accounts secured by the attached Birth Certificate and the property to
which it relates for FIRST MIDDLE LAST a Public Register State Agency, Estate, held in
Trust; and that;

4. The Executor has authenticated the FIRST MIDDLE LAST a Public Register State
Agency, Estate, held in Trust; and that;

5. Last: First-Middle, private real man, not an entity, has resigned as resident agent and register
office (MCL 450.1243, Michigan) for the FIRST MIDDLE LAST a Public Register State
Agency, Estate, held in Trust; and that;

6. The Executors states the day of birth is Month date, year; and that;

7. The Executors states the place of birth is near the geographical location commonly known as
Detroit, Michigan, an entity formed within the constitutional republic of the United States of
America, in an outlying possession of the United States; and that;

8. The Executor is the holder in due course securing 100% of the beneficial interest in the
property, FIRST MIDDLE LAST a Public Register State Agency, Estate, held in Trust to
which this affidavit relates, and that;

9. The Executor has the sole power to accept, receive, transfer, disburse, or convey 100% of the
proceeds profits, income, and revenue arising out of the property of FIRST MIDDLE LAST
a Register State Agency, Estate, held in Trust relates; and that,
10. The Executor holds all investment powers, which includes the power to dispose, or to direct
the disposition of, such portion of the FIRST MIDDLE LAST a Public Register State
Agency, Estate, held in Trust; and that,

11. The Executor authorizes this affidavit to be provided to any withholding agent/nominee that
has control, receipt or custody of the profits, proceeds, revenue, holder of the debt instrument or
income derived from the property subject to the attached FIRST MIDDLE LAST a Public
Register State Agency, Estate, held in Trust.

12. The Executor shall also overstand government entities and profitable corporations related to
the FIRST MIDDLE LAST a Public Register State Agency, Estate, held in Trust with an
associated Social Security No. (SSN) XXX-XX-XXXX. All points mention above applied to the
SSN as well.

13. The Executor shall acknowledge the attached Authenticated State of Michigan Certificate
of Authority seal, recorded #XXXXXX-X-XXXXXX-XXX.

14. The Executor shall acknowledge the attached Authenticated United States of America,
Department of State Certificate of Genuineness Foreign seal, recorded#XXXXXXXX-X.

15. The Executor being an Occupied of the Office of the FIRST MIDDLE LAST a Public
Register State Agency. Below is a picture of the living man, Executor.
I hereby declare under penalty of perjury that the above information is complete, correct, and
true to the best of my knowledge and law.

(Seal)

autograph by______________________________________
Last: First-Middle, Executor Date
FIRST MIDDLE LAST a Public Register State Agency, Estate

JURAT

STATE OF (YOUR STATE) }

}ss
COUNTY OF (YOUR COUNTY) }

On _____________ before me, ____________________________, Notary Public, personally

appeared before me _Last: First-Middle_, who proved to me on the basis of satisfactory evidence
with _Passport_ID & Photo type to be the man whose name is subscribed to within this
instrument and acknowledged to me that he executed the same in his authorized capacity and that
by his autograph on the instrument, the man acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of Your State that the
foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Signature ______________________________ (Seal)