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IN THE CIRCUIT COURT OF THE NINETEENTH JUDICIAL CIRCUIT AND IN FOR

SAINT LUCIE COUNTY, FLORIDA. (REPLACE WITH YOUR COURT’S HEADING)

) CASE NO: ____________

)
)
) JUDGE: _____________
(Your Free Name) )
(Affiant) )
________________________)

AFFIDAVIT OF LIVE BIRTH

The affiant, (Your Free Name), in Propria Persona (my own proper self), formerly known as the
artificial person, (STRAWMAN NAME), is a Noble of the Washitaw Nation of Muurs (Moors),
better known as, “Uaxashaktun de Dugdahmoundyah,” also known as, “Amurru Washitaw de
Dugdahmoundyah,” which is an off branch of the Kushite Empire, the Ottoman Empire, and the
Songhai Empire, which later became the Al-Moroccan Empire; to wit: North, South, Central
America, and including the adjoining Islands; upon his inherited Nobility, and upon his private
Aboriginal/Indigenous, “In Full Life,” status and commercial liability, I, (Your Free Name),
being duly affirmed under Consanguine Unity; pledge my national, political, and spiritual
allegiance to my Moabite/Moorish Nation; being the archaic Aboriginals/Indigenes of
Amexem/Ameru/Amurru/Al-Moroco/Amaru-Ka/Amen-Ra-Ka (the Americas), standing squarely
affirmed upon my Oath to the ‘Five Points of Light’ - Love, Truth, Peace, Freedom, and Justice;
deposes as follows: (If you’re not a Moor (Black) just simply say, “The affiant, (Your Free
Name), in Propria Persona (my own proper self), formerly known as the artificial person,
(STRAWMAN NAME), deposes as follows under oath:”

The affiant is not a lawyer and his pleadings cannot be treated as such. In fact, according to
Haines v. Kerner, 404 U.S. 519 (1972), a complaint, "however inartfully pleaded," must be held
to "less stringent standards than formal pleadings drafted by lawyers" and can only be dismissed
for failure to state a claim if it appears "beyond doubt that the plaintiff can prove no set of facts
in support of his claim which would entitle him to relief." Id., at 520-521, quoting Conley v.
Gibson, 355 U.S. 41, 45-46 (1957).

“Indeed, no more that affidavits is necessary to make a prima facie case.” (See United States v.
Kis, 658 F. 2nd, 526, 536 (7th Cir. 1981): Cert Denied, 50 U.S.L.W. 2169; S. Ct. March 22,
1982.)

1.) I, (Your Free Name), being first duly sworn, deposes and says that he is of the age of 33
years; that he resides at, In care of (Address), (City), (State), [Zip].
2.) The affiant asserts that he is the Secured Party Creditor/Authorized Representative of
Debtor, (STRAWMAN NAME), a petitioner for registration of birth with the state of
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(Your State); that said petitioner was born on the 1st day of February, 1979, at Lawnwood
Hospital in Fort Pierce, Florida. (See attached endorsed Birth Certificate that verifies the
date of Birth of Debtor.)
3.) The affiant asserts that he has personal knowledge of these facts and that he is making
this affidavit for the purpose of verifying and/or certifying the birth date of (Your Free
name), Formerly known as STRAWMAN NAME.
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VERIFICATION

STATE OF ______________

SS. AFFIDAVIT

COUNTY OF ____________

I, (Your Free Name), pursuant to title 28, USC Section 1746 (1) and executed “Without the
United States,” I affirm under the penalty of perjury under the laws of the United States of
America that the foregoing is true and correct, to the best of my belief and informed knowledge

Signed on this ____ day of _______________ 2013, by the undersigned authority:

______________________________
Secured Party Creditor/Authorized Representative
All Rights Reserved Without Prejudice;
U.C.C. 1-207/1- 308, U.C.C. 1-103.
(Your Free Name)
(Your address)
(City), (State) [zip].
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CERTIFICATE OF SERVICE

I hereby certify that a true and correct copy of the foregoing affidavit has been furnished by US
Mail to: The Clerk of The Circuit Court, Register/Recorder of deeds, P. O. Box 700, Fort Pierce,
Florida, 34954; The Clerk of the Circuit Court , P. O. Box 700, Fort Pierce, Florida, 34954; the
State Attorney’s Office, 411 South Second Street, Fort Pierce, Florida, 34950; the Office of the
Attorney General, Sate of Florida, The Capitol PL-01., Tallahassee, FL 32399-1050; the Florida
Department of State, Secretary of the State, R. A. Gary Building, 500 S. Bronough, Tallahassee,
FL. 32399-0250; and The US Department of the Treasury, 1500 Pennsylvania Avenue, NW
Washington, DC 20220, on this ___day of ____________________, 2013.(Change addresses to
your local state and/or county officials)

Respectfully Submitted
by:______________________
Affiant, (Your Free Name).
All Rights Reserved Without Prejudice;
U.C.C. 1-207/1-308, U.C.C. 1-103.
(Your Free Name)
(Your Address)
(City), (State) [zip].