Common Carry Declaration

I, Derrick Jackson, a living woman over the age of 21, a declared American State National, of
sound mind and body, do affirm and declare that I responsibly exercise my right to bear arms, as
a peaceful, private American, in fulfilling my duty to uphold the public law and keep the peace, I
will utilize my weapons through visible or concealed carry as is appropriate.

So signed and sealed this _______ day of _____________________, 2022.

___________________________________________
by: Derrick Jackson©
All Rights Reserved
Without Prejudice

Notary Witness and Acknowledgement

Michigan State
Wayne County

Today before me, a Commissioned Notary, is the living man known to me to be Derrick Jackson and he
did issue this Common Carry Declaration as shown before me this ______day of __________________in
the year 2022, in Witness whereof I set my Signature and Seal:

_________________________________ Public Notary; my commission expires on: ________________.

SEAL

Revi06202021