Cancellatura

NON-NEGOTIABLE NON-TRANSFERABLE THIS IS A PRIVATE MATTER TITLE OF ORIGIN

This is a permanent legal document and remains the property of the Authorized Representative and
may not be reproduced without prior written permission of Authorized Representative. 
notice to the agent is notice to the principal; notice to the principal is notice to the agents 
herein claimed, declared, expressed, and stated as true, correct, complete and not misleading

[Autographed, dated, 
sealed Red Fox stamp here]

From:

[NAME]
c/o [NOTARY], NOTARY PUBLIC
[NOTARY ADDRESS]
[NOTARY CITY, ST NOTARY ZIP]

For Respondents:
 SECRETARY OF STATE OF THE UNITED STATES
Registered Mail #

 SECRETARY OF THE TREASURY 

Registered Mail #

 COMMISSIONER OF INTERNAL REVENUE

Registered Mail #

 COMMISSIONER OF INTERNAL REVENUE PUERTO RICO  

Registered Mail #

 SOCIAL SECURITY ADMINISTRATION

Registered Mail #

 IMMIGRATION AND NATURALIZATION SERVICE

Registered Mail #

 PORT AUTHORITY Registered Mail #

 SECRETARY OF STATE OF [STATE] Registered Mail #

 [STATE] ATTORNEY GENERAL Registered Mail #

OFFICE OF THE ATTORNEY GENERAL

DEPARTMENT OF JUSTICE

 INTERNATIONAL MONETARY FUND Registered Mail #

Cancellatura

I. Introductory Certification

[Name], the living principal autographing hereunder, hereinafter "Claimant," does hereby solemnly
certify, state, and claim that:

1. Claimant can competently state the matters set forth herewith.

2. Claimant has personal knowledge of the facts stated herein.

3. All the facts stated herein are true, correct, complete, certain, admissible as evidence, and not
misleading in accordance with Claimant’s best knowledge and understanding. 

II. Capacity of Claimant

A. Claimant herewith provides actual and constructive notice to Respondents and all men that Claimant
operates concerning this and all matters within the sole, exclusive, and original jurisdiction, hereinafter
“Original Jurisdiction,” of Claimant’s inherent union and eternal Covenant with the Creator, established
“before the foundation of the world,” in accordance with which Claimant executes this Cancellatura,
hereinafter “Cancellatura”:

1. As a living, sentient, eternally free, and spiritually autonomous being;

2. Knowingly, willingly, and intentionally;
3. In good faith;
4. In just cause as steward of Claimant’s life; 
5. In peace;
6. Not in time of war;
7. Not under any emergency war powers;
8. For the purpose of furthering amicable relations, expeditious resolution, and genuine meeting
of minds with Respondents and all involved parties re this instant matter;
9. With no intention for obstructing any true, just, and lawful proceeding;
 10. With full intention for preserving and promoting confidence in the integrity, fairness,
justness, and equality of the law.

B. Claimant further acts in this instant matter as plenipotentiary for [NAME], hereinafter [LAST NAME],
and any orthographic representation of [NAME] as might be construed as pertaining to Claimant in any
manner, pending receipt from Respondent by [Notary], hereinafter “Notary,” a notary public acting for
and on behalf of [LAST NAME], of Respondent’s superior proof of claim on [LAST NAME] in accordance
with the terms and conditions set forth herein.

III. Intent of Claimant

Animus ad se omne jus ducet. It is to the intention that all law applies.

Animus hominus est anima scripti. The intention of the party is the soul of the instrument.

A. Cancellatura provides open, notorious, formal notice to all men and all creation of the sovereign
intent of Claimant to:

1. Live as a free, spiritually autonomous, sentient being in the Kingdom of God, in accordance with
Original Jurisdiction, as expressed within, by, and through the spiritual, ecclesiastical
organization [name of SSM], as signified, inter alia, by Cancellatura and a true and complete
copy of the following items of substantiation attached herewith, enclosed herein by reference,
and made fully part hereof:

1. UCC Financing Statement wherein all property and rights in property of [NAME] are
pledged to [name of SSM];

2. Claimant’s voluntary commitment, hereinafter “Commitment,” to live within, under, and

in accordance with Claimant’s Covenant with the Creator in harmony and unity with the
ecclesiastical law, jurisdiction, principles, and purposes of [name of SSM];

3. Certificate of Execution of An Unincorporated Organized Self-Supported Spiritual

Ministry;

4. Minutes of the meeting of the Directors of [name of SSM] indicating acceptance by the
full Board of Directors of Claimant’s Commitment;

5. Currently held original [State] driver license and identification card, returned to [DMV]
herewith;

6. Currently held original United States Passport, returned to the United States
Department of State herewith.

2) Live in peace with all people and not at war with any aspect of the Creator’s Creation, in
 accordance with which intent Claimant proclaims a neutral, non-combatant, non-belligerent, in
itinere status, devoid of ill will towards any aspect of the Creator’s creation and aspiring towards
harmonious interactions with all for the highest good of all creation.

3) Exercise the innate and unalienable right of Claimant to live in unalloyed freedom, self-
sufficiency, and sovereignty in the Kingdom of God, Original Jurisdiction, without interference,
let, or hindrance, and be thereby “in the world but not of it.”

4) Live in the service of the Creator, owning nothing, not possessing legal title to anything.

5) Complete abstention from swearing any oaths of any kind, in accordance with such
utterances as: “But above all things, my brethren, swear not, neither by heaven, neither by the
earth, neither 

B. Claimant executes Cancellatura on the basis of Claimant’s mistake, inadvertence, ignorance,

insufficient wisdom, and inadequate development of conscience in Claimant’s developmental years
concerning any signatures of [LAST NAME], and expressly holds Respondent harmless for any past
actions of Claimant, nunc pro tunc.

C. Claimant likewise provides Respondent with Cancellatura for the purpose of exhausting
administrative remedies and thereby, if deemed appropriate, engage in obtaining redress of grievances,
remedy, and relief, both judicially and otherwise, concerning any trespass or damages to, or abrogation
of rights experienced by, Claimant deriving from the subject matter set forth herein.

D. Claimant does herewith cancel, extinguish, rescind, revoke, abrogate, annul, nullify, disavow,
disclaim, renounce, and render null and void ab initio:

1. All signatures on any and all documents that might be construed as binding, obligating,
subordinating, or entangling Claimant with any organization, government, quasi-government,
agency, political entity, private party, or legal person in opposition or contradistinction to the
nature of Claimant’s solemn Covenant with the Creator in Original Jurisdiction.

2. All warrants and powers of attorney, and all agency agreements, both express and implied, on
the basis of which Respondent may be acting in relation to Claimant.

3. All connection, nexus, minimal contact, and contractual relationship of Claimant, and all
presumption thereof, with any actual or presumed aspect of existence other than as exists
within and accords with Claimant’s Original Jurisdiction.
 4. Any alleged oaths Claimant may have sworn in the past, for and on behalf of [LAST NAME] or
otherwise, and all rights, privileges, and immunities that may be construes as having been
surrendered or granted by Claimant on the basis of said presumed oaths.

E. Claimant herewith particularly provides Respondents with express notice of Claimant’s cancellation,
extinguishment, rescission, revocation, abrogation, annulment, nullification, disavowal, disclaiming,
renunciation, and voiding ab initio and nunc pro tunc of:

1. The alleged signature of [LAST NAME] on the Social Security Form SS-5 purportedly signed by Claimant
on behalf of [LAST NAME] in Claimant’s youth;

2. All and every alleged signature of [LAST NAME], purportedly signed by Claimant on behalf of
[LAST NAME], on each and every previously executed IRS form 1040 of [LAST NAME];

3. All and every alleged signature of [LAST NAME], purportedly signed by Claimant on behalf of
[LAST NAME], on each and every State driver license of [LAST NAME];

4. All and every alleged signature of [LAST NAME], purportedly signed by Claimant on behalf of
[LAST NAME], on each and every United States Passport of [LAST NAME];

5. All and every alleged signature of [LAST NAME], purportedly signed by Claimant on behalf of
[LAST NAME], on each and every document or instrument of any kind whatsoever that may be
construed by any person as binding, obligating, encumbering, or limiting [LAST NAME] in any
manner.

IV. Jurisdiction and Citizenship of Claimant

A. The Ecclesiastical Law of [name of SSM], and Claimant’s eternal Covenant with the Creator, Original
Jurisdiction, are one with and expressions of the ultimate, eternal, uncreated Law of the unbounded and
unfathomable Source of All-That-Is, and transcend, but are not necessarily disharmonious with, all
archetypes, conventions, and belief systems of mankind, individual and collective, conscious and
subconscious.

B. In accordance with the foregoing, Claimant proclaims, avows, and attests before the Creator and all
men Claimant’s absolute, irrevocable, and exclusive citizenship of Claimant as a “Citizen of the Kingdom
of God” within Original Jurisdiction, in accordance with which Claimant renounces, disclaims, and
disavows utterly all claims, implications, presumptions, allegations, and inferences that Claimant may be
classified or lawfully regarded as:

1. A “citizen of the United States”;

2. Within or subject to the so-called “Fourteenth Amendment” to the Constitution of the United States;
3. A citizen of any man-made, civil-law government of any nature whatsoever;
4. Accepting any benefits, whether express, implied, or compelled, from any source whatsoever other
than from and as provided by the Creator;
5. Within, subject to, holds any political allegiance to, is contractually involved with, or may be
construed as possessing minimal contact with, any jurisdiction of any nature other than Original
Jurisdiction.

V. Release of Liability

A. Claimant herewith notices Respondents that Claimant forever releases Respondents of all
liability, nunc pro tunc, concerning any aspect of this instant matter, and expressly indemnifies and holds
Respondent harmless concerning all matters connected with the cancellations, renunciations, and
disavowals of Claimant set forth herein.

VI. Options

A. Claimant herewith respectfully requests that Respondent provide Notary, within ninety (90) calendar
days of midnight of the day of Respondent’s receipt hereof, hereinafter “Stipulated Time,” with
whichever of the following four (4) options Respondent elects:

Option 1: Formal notice, with both official and personal responsibility, that Respondent regards all
signatures of Claimant on any document, instrument, or form in any system of records of Respondent
and any and all Principals, Agents, Representatives, Agencies, and Entities of any kind with which
Respondent may be involved, as annulled, extinguished, and rendered non-existent, and that all
obligations, both express and implied, connected therewith are permanently and completely excised,
abolished, and expunged from all applicable systems of records concerning either Claimant or [LAST
NAME].

Or, in the alternative,

Option 2: Request for enlargement of time for good cause shown.

Or, in the alternative,

Option 3: Documentary proof of claim on the record, by competent witness, of each and every required
item, hereinafter “Required Item,” cited by Claimant hereunder as conditions precedent for any further
proceeding against [LAST NAME] or Claimant concerning the subject matter set forth herein;
Or, in the alternative,

Option 4: Silence and non-response by Respondent as signified by non-receipt by Notary within

Stipulated Time of either of the three (3) options set forth in the immediately preceding paragraphs, i.e.,
“Option 1,” “Option 2,” or “Option 3,” supra.

VII. Negative Averments, Conditions Precedent, and Consequences

A. In the event Respondent provides Notary, within Stipulated Time, with notice of Respondent in
accordance with Option 1, supra, this matter is deemed irrevocably closed, consummated, and mutually
stipulated to by and between Claimant and Respondent, with no further action required by [LAST
NAME], Claimant, Respondent, or otherwise.

B. In the event Respondent provides Notary, within Stipulated Time, with request for enlargement of
time as set forth in Option 2, Claimant grants said enlargement for a period of time not exceeding thirty
(30) days beyond the termination of the Stipulated Time of ninety (90) calendar days.

C. In the event Respondent acts in accordance with Option 3, supra, Respondent must provide Notary,
within Stipulated Time, with each and every one of the enumerated required items, hereinafter
“Required Items,” negatively averred by Claimant and proposed as conditions precedent for any action
of any kind against [LAST NAME], set forth as follows:

1. Documentary proof by an identified Real Party of Interest, with contact parameters provided,
verifying and validating any alleged a priori claim on the life of Claimant other than that of the
Creator.

2. Documentary proof by an identified Real Party of Interest, with contact parameters provided,
verifying any actual, express, implied, constructive, or presumed claim on [NAME].

3. Clarification, with particularity, of the origin, nature, and significance of the assemblage of
letters consisting of “[NAME],” as said assemblage of letters may affect or be presumed to affect
Claimant in any manner.

4. The complete chain of delegation of authority, originating from an identified Real Party of
Interest, i.e., Principal, concerning this instant matter, whereby Respondent may exercise lawful
delegated authority for acting against [LAST NAME] in any manner adverse to Claimant.
5. Proof that all delegation orders referenced in the paragraph immediately above are duly
published in the Federal Register as required, inter alia, by the Administrative Procedures Act, 5
USC § 552(a)et seq., and the Federal Register Act, 44 USC § 1501 et seq.
6. A true bill, executed by authorized party certified true, correct, and complete, stating the
sum-certain amount of the purported obligation that [LAST NAME] may be obligated to
discharge for closure of the accounting re this instant matter based on a proven, bona fide
assessment and proof of claim.
7. Certified, true copy of all documents used for calculating the above-referenced sum-certain
obligation, i.e., full accounting of how the sum-certain amount of the assessed obligation was
calculated.
8. Certified, true copy of the foundational, underlying contract, hereinafter “Contract,” with
bona fide signature of all involved parties thereon, on the basis of which any lawfully
enforceable claim against [LAST NAME] or Claimant is based, satisfying all requirements for the
existence of a valid contract enforceable at law, such as, inter alia:
 a. Genuine agreement between the parties borne of mutual good faith, full disclosure,
and genuine meeting of the minds;
b. Offer and acceptance;
c. Competency of all parties to contract;
d. Valuable consideration provided to [LAST NAME] by Respondent or a Real Party of
Interest Respondent represents;
e. Lawful object;
f. Absence of fraud, duress, undue influence, malice, and mistake.

9. Affidavit or asseveration by authorized party(s), notarized and certified true, correct, and
complete under penalty of perjury, setting forth:

a. Identification with particularity of the terms and conditions of Contract, whether

maritime or otherwise, concerning which Claimant allegedly owes a purported
obligation;
b. All commercial paperwork, i.e., all bookkeeping and accounting, substantiating every
allegation that [LAST NAME] or Claimant owes the sum-certain amount of the assessed
obligation based on the terms and conditions of Contract, executed under affidavit or
asseveration certified true, correct, and complete by all involved parties, and staking
defined commercial liability on the validity, veracity, accuracy, relevance, and
verifiability of each and every assertion and entry in said commercial paperwork;
c. Identification with particularity of all creditors to whom Claimant allegedly owes what
corresponding sum-certain amount of a particular kind of funds based on the terms and
conditions of Contract;
d. Defined identity of all parties for whom Claimant must allegedly render specific
performance based on the terms and conditions of Contract;
e. The remedy and relief sought by Respondent, or any other being, person, or entity
enforcing the terms and conditions of Contract, including, but not limited to, the precise
form of currency, defined with particularity, that [LAST NAME] or Claimant may by law
be compelled to tender in satisfaction of any alleged obligation.

10. Proof that without a valid and lawfully enforceable claim and bona fide assessment, supra,
Respondent possesses lawful authority for asserting that [LAST NAME] owes any purported
obligation or specific performance concerning this instant matter.

1. Basis upon which Claimant may not tender any type of funds, such as gold and silver
coin of the United States as per the Coinage Act of 1792, hereinafter “Constitutional
Money,” Federal Reserve Notes, Italian Lira, Swiss Francs, “Monopoly Money,” or pieces
of paper with digits inscribed thereon, for satisfying any obligation or judgment asserted
by Respondent against [LAST NAME] or Claimant in the absence of proof for the record
of the lawfully established money of account, defined with particularity, that [LAST
NAME] or Claimant may be compelled to tender for satisfying any alleged obligation
imposed on [LAST NAME] or Claimant.
 2. Statement whether [LAST NAME] is creditor or debtor in Respondent’s system of
records and on what basis.

3. The precise instrument and particular form of funds [LAST NAME] may tender for
discharge of the assessed sum-certain obligation re this instant matter, e.g.:

a. The text and form of a particular bill of exchange, pre-authorized transfer,

draft, assignment of account, and the like, that Respondent accepts for
discharge in full of the sum-certain amount of the assessed obligation by
Claimant through use of Claimant’s exemption; or, in the alternative,

2. Official notification from Respondent that Claimant may execute any instrument of
Claimant’s choice for discharge of the assessed obligation through offset and
adjustment against Claimant’s exemption without recourse to Claimant; or, in the
alternative,

3. Agreement that Claimant may tender Constitutional Money for payment in full of the
assessed, sum-certain obligation.

4.

D. In the event Respondent acts in accordance with Option 4, said course of action, i.e., nihil
dicit, by Respondent constitutes authority for Claimant to undertake a notarial process upon the
conclusion of which Notary’s providing Respondent with a Certificate of Non-Response
constitutes proof for the record of Respondent’s stipulation, by stare decisis, tacit procuration,
and estoppel in pais, that:

1. No Required Item exists that is not proved for record;

2. Respondent agrees in full with each and every statement and aspect of Cancellatura and no
controversy exists over any matter set forth herein;
3. Respondent is neither the creator of, nor can Respondent fathom, encompass, conceptualize,
or invalidate, the nature, source, and authority of Original Jurisdiction nor the rights, privileges,
and immunities of Claimant existing within and deriving from Claimant’a Covenant with the
Creator;
4. Respondent waives any and all claims of any nature against Claimant and [LAST NAME];
5. Claimant is absolved of any and all possibility for being presumed guilty, by any being and in
any jurisdiction of law whatsoever, of any wrongdoing for disregarding any ruling, order,
summons, warrant, complaint, cause of action, notice of default, entry of default, and the like
deriving from this instant matter on the basis of Respondent’s stipulations set forth herein;
6. All participants functioning for and on behalf of Respondent may be sued in the personal
capacity of each participant, devoid of official immunity, in accordance, inter alia, with the
provisions of 1) the Suits in Admiralty Act, 46 USC, Appendix, Chapter 20 §§ 742-749; 2) the Bill
of Lading Act, 49 USC, Chapter 147 § 14706; 3) the Admiralty Extension Act, 46 USC Appendix,
Ch. 19-A § 740; 4) the Foreign Sovereignty Immunity Act, 28 USC 1605; 5) the Public Vessel Act,
 46 USC Chapter 22 § 781, for any damages inflicted on Claimant or [LAST NAME] re this instant
matter;
7. All beings, entities, governments, organizations, and persons are hereafter barred and
estopped from engaging in any action of any kind against any interests of Claimant re this
instant matter, such as seizing, transferring, confiscating, collecting upon, etc., any assets of
[LAST NAME] as may affect Claimant;
8. Any incarceration of Claimant’s physical body constitutes express grant of authority for
Claimant to invoice and commercially collect for damages from each and every involved party re
this instance matter in substance-equivalent of the sum-certain amount of Sixty-five Thousand
Two-hundred Seventeen and 91/100 United States Dollars ($65,217.91) per each and every hour
incarcerated, i.e., One Million Five-hundred Sixty-five Thousand Two-hundred Seventeen and
30/100 United States Dollars ($1,565,217.30) per each twenty-four (24) hour day of
incarceration, plus punitive damages in an amount decided exclusively by Claimant, as per
precedent, Trezevant vs. City of Tampa, 741 F2d 336, 1984, which amount inures for the benefit
of Claimant’s heirs and assigns in the event of any incapacity of Claimant;
9. The department risk management of any involved party proceeding against [LAST NAME] or
Claimant waives any and all defenses and must pay any claim for damages filed against said
department of risk management, in accordance with the terms and conditions set forth herein,
immediately, upon demand, without protest, impound, delay, deduction, impost, or duty;
10. All entries of name of Claimant and [LAST NAME] must be removed from all systems of
records of Respondent re this instant matter;
11. All stipulations of Respondent established on the record in this instant matter are final,
conclusive, and constitute forever a bar of authority for either party to invoke any controversy
concerning the subject matter of said stipulations;
12. No judge in any court may consider any matter concerned with any stipulation of
Respondent established on the record in this instant matter;
13. Any judge possesses only ministerial duty, and is devoid of judicial discretion, concerning
Respondent’s stipulations established on the record in this instant matter;
14. Claimant may engage in any appropriate and lawful means for remedy and recourse for any
damages inflicted on Claimant, both legal and commercial, as Claimant, in accordance with the
Tribunal of [name of SSM], operating in the Ecclesiastical Law of [name of SSM] in Original
Jurisdiction, may deem appropriate.

VIII. Verification

A. Name, i.e., “Claimant,” does herewith certify, state, and claim that Claimant executes this
Asseveration with sincere intent, possesses competence for stating the matters set forth herein, and
declares, upon Claimant’s unlimited commercial liability, that the contents are true, correct, complete,
and certain, admissible as evidence, and not misleading in accordance with Claimant’s best knowledge
and understanding.

NOTICE TO THE PRINCIPAL IS NOTICE TO THE AGENTS

NOTICE TO THE AGENTS IS NOTICE TO THE PRINCIPAL
Autograph of [Name], Claimant: Claimant’s right thumbprint
Enclosures/Attachments:

 Certificate of Service

 UCC Financing Statement wherein Claimant is Debtor and [name of SSM] is Secured Party
concerning all property and rights in property of Claimant

 Certificate of Execution of An Unincorporated Organized Self-Supported Spiritual Ministry;

 Minutes of the meeting of the Directors of [name of SSM] indicating acceptance by the full
Board of Directors of Claimant’s Commitment;

 Currently held original [State] driver license and identification card, returned to [DMV] herewith;

 Currently held original United States Passport, returned to the United States Department of
State herewith.

ACKNOWLEDGEMENT

State of [State] ) [Autographed, dated, sealed

) ss Red Fox stamp here]
County of [County] )

Subscribed, verified, and attested to before this agent, ______________________________________, a

notary public in and for the County of [County], State of [State], on this __________ day of
________________, 200? by [Name], who proved to this agent on the basis of satisfactory evidence that
[Name] solemnly executes the within document and certifies that [Name] is the claimant and living
principal in this matter.

Witness my hand and official seal. ____________________________________________ 

Signature of Notary
My commission expires ____________________________________________________

Respond within ninety (90) days to: 

[Notary], Notary Public, 

[Notary Address], 
[Notary City, ST Zip]