INSTRUCTIONS
You must complete the following before calling an intake receptionist, if you have any questions you may
call a receptionist for clarity
1) Print out and Complete the Application PRINT CLEARLY - 2 pages attached
2) Print out and fill in the blanks on the “Power of Attorney” PRINT CLEARLY & notarized 2pgs
3) Type out an Affidavit and have it notarized – you must create using word or note pad.
Write your affidavit using MS Word or Notepad, an Affidavit is your story concerning the violations
committed against you and your family by the workers, judges, lawyers etc. Give factual details and stay
on point, do not exaggerate or lie that would be perjury and you could go to jail, when unsure of dates and
times use the phrase on or about.
Follow the following format, use as many pages as necessary starting with a header and ending with a
footer, but remember “less is more” do not put in unnecessary details and story-telling just the facts in
chronological order:
When your paper work is completed (1-3 above) call an intake receptionist for your state for further
instructions.
You will be instructed on what
to write here
State _____ #__-___ United States District Court for the _________________ County ______________
Affidavit of
Your Name
Header
I Your Name, Affiant, being of lawful age, qualified and competent to testify
to and having firsthand knowledge of the following facts do hereby swear that
the following facts are true, correct and not misleading:
TELL YOUR DETAILED STORY HERE
(note that the subscriber below is the Notary)
If your children are still in your home make sure you note that you and your
children are being forced to participate in their court against your will. If you
are extended family (grandma, sibling, etc.) and guardian make that clear.
Your Sworn Statement
X ______________________________
NOTARY
YOUR State, YOUR County on this _____ day of _____________, 2013
before me __________________, the subscriber, personally appeared YOUR
NAME to me known to be the living (wo)man describe in and who executed
the forgoing instrument and sworn before me that he executed the same as his
free will act and deed.
Footer
___________________________
Notary
My commission expires: ______
(Notary Seal)
STATE ___________________ #_____-_________ United States District Court for the _________________________________ County ____________________
IN-TAKER’S NAME ____________________________ PHONE ____-____-_______ EMAIL _____________________________________________________
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - ~ DO NOT FILL OUT THE INFORMATION ABOVE YOU WILL BE INSTRUCTED BY THE INTAKE RECEPTIONIST WHEN YOU CALL ~
PLEASE PRINT CLEARLY AND FOLLOW THE INSTRUCTIONS CAREFULLY - (1) Leave the above blank until you call and you will be instructed on
the above information. (2) Go to www.NationalLibertyAlliance.org and become a member in order to be put onto our email list. Read the front page and watch the
videos to understand who NLA is and what we stand for. Join our Monday night call 9PM EST, we will inform you by email of other up-coming teleconference
meetings to keep you informed. (3) Fill out this form completely (4) Write an affidavit in Word or Notepad, an Affidavit is your story concerning the violations by
the workers, court, lawyers and etc. Give factual details and stay on point, do not exaggerate or lie that would be perjury and you could go to jail, when unsure of
dates and times use the phrase on or about. (5) You will need to e-mail this application and affidavit to the intake receptionist who will then put your story in
affidavit form and e-mail it back to you. (6) You will then need to print out the affidavit, have it notarized and mail it to the address you will be given by the intake
receptionists. Once we have all your paperwork we will call to confirm that you are on the lawsuit, if you do not hear back from us in 7 days you can call the intake
receptionists for confirmation. (7) You “MUST” attend the teleconference meetings for further instructions and to answer any questions you may have.
YOUR NAME ________________________________________ PHONE ____-_____-________ E-MAIL __________________________________________
ADDRESS _____________________________________________________ CITY _________________________ STATE _______________ ZIP __________
COUNTY ________________________________
Write below the status of your children, have they been removed, where are they, min details?
CHILDREN’S NAMES AND THEIR STATUS ____________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
COURT NAME _______________________________________ PHONE ____-____-________
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
JUDGES NAME _________________________________ CLERKS NAME ______________________________
WORKER’S NAME ___________________________________ PHONE ____-____-________
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
Name all lawyers involved yours, your children’s, etc…
#1 LAWYER’S NAME _________________________________ PHONE ____-____-________
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
#2 LAWYER’S NAME _________________________________ PHONE ____-____-________
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
#3 LAWYER’S NAME _________________________________ PHONE ____-____-________
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
Page 1 of 2
#4 LAWYER’S NAME _________________________________ PHONE ____-____-________
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
OTHER ______________-_______________________________ PHONE ____-____-________
Title
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
OTHER ______________-_______________________________ PHONE ____-____-________
Title
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
OTHER ______________-_______________________________ PHONE ____-____-________
Title
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
OTHER ______________-_______________________________ PHONE ____-____-________
Title
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
OTHER ______________-_______________________________ PHONE ____-____-________
Title
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
OTHER ______________-_______________________________ PHONE ____-____-________
Title
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
OTHER ______________-_______________________________ PHONE ____-____-________
Title
FAX ____-____-________ COUNTY ___________________
ADDRESS ___________________________________________ CITY ___________________________ STATE ____________________ ZIP _____________
NOTES: ___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Page 2 of 2
STATE __________________ #_____-________ United States District Court for the ______________________________ County __________________
IN-TAKER’S NAME _________________________ PHONE ____-____-_______ EMAIL _________________________________________________
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - ~ DO NOT FILL OUT THE INFORMATION ABOVE YOU WILL BE INSTRUCTED BY THE INTAKE RECEPTIONIST WHEN YOU CALL ~
COMMON LAW POWER OF ATTORNEY
ARTICLE I
APPOINTMENT
I (we) _____________________________ People of ____________ County, __________ State, revoke all prior
powers of attorney executed by me and "decree" National Liberty Alliance (NLA) and/or the Unified United
States Common Law Grand Jury, to serve as my common law private attorney1, next friend2, with the power to
act on my behalf as authorized by this instrument, in a Common Law Joint Action3 Suit seeking Justice and
Restitution and to act on my/our behalf as lawful council and decision maker concerning this joint action.
ARTICLE II
SCOPE AND DURATION
II.
This common law power of attorney4, unrestricted by any state or federal statutes or codes5, is:
II.1
A common law power of attorney, effective from the date it is executed, until action is settled.
II.2
The powers granted by this common law power of attorney shall become effective upon the signing of
this instrument below.
ARTICLE III
POWERS
III.
Except as specifically limited in this instrument, my common law private attorney shall have all the
powers incident to a general power of attorney under the common law, and shall also have full authority to take
any actions necessary or incident to the execution of these powers, as fully as I could do if personally present.
These powers shall include:
III.1
My obligations, the power to compromise, settle, defend and satisfy any obligations of mine or any
demands made on me as my common law private attorney deems advisable;
III.2
Obligations of others, the power to collect, demand, represent in pro per, vice mea6, in a court of law,
sue for, and receive all debts, moneys, security for money, goods, chattels or other personal property to which I
am entitled, and to settle or compromise the same as my common law private attorney deems advisable, of
which 10% of all of the aforesaid collected shall be retained and donated to NLA;
1
ATTORNATUS. One who is put in the place of another; a substitute; 7 C.J.S. p. 694.; PRIVATUS - private
Federal Rules of Civil Procedures, Rule 17, “A next friend is a person who represents someone who is unable to tend to his or her own interest .”
JOINT ACTION. An action brought by two or more as plaintiffs or against two or more as defendants.
4
POWER OF ATTORNEY. [Black's Law 4th edition, 1891] An instrument authorizing another to act as one's agent or attorney. A letter of attorney.
Arcweld Mfg. Co. v. Burney, 12 Wash.2d 212, 121 P.2d 350, 354; Olive-Sternenberg Lumber Co. v. Gordon, Tex.Civ.App., 143 S.W.2d 694, 698.
5
The common law is the real law, the Supreme Law of the land, the code, rules, regulations, policy and statutes are “not the law”, [Self v. Rhay, 61 Wn
(2d) 261]
6
VICE. Lat. In the place or stead. Vice mea, in my place.
2
3
III.3
The power to defend against and/or counter sue in an action at law7, in pro per, any officer of the de
facto court or any other authority acting under in a court of record;
ARTICLE IV
GENERAL PROVISIONS
IV.1 Inducement of Reliance. All persons dealing with my common law private attorney may rely
exclusively upon the original or a photocopy of this document, which is intended to give my common law
private attorney complete authority over my legal issues, I and my heirs, legal representatives, successors and
assigns will hold such party or parties harmless from any loss suffered or liability incurred by me or my private
attorney and will indemnify such party for any such loss or liability incurred by such party in acting in
accordance with this common law power of attorney prior to such party's receipt of a written notice executed by
me of any such termination or modification.
IV.2 Records. My common law private attorney shall keep complete records of all transactions that he enters
into on my behalf and shall render such reports and accounts as are required by me.
IV.3 Governing Law. This common law power of attorney shall be governed by Common law in all respects
including its validity, construction, interpretation and termination.
This instrument was drafted by Unified United States Common Law Grand Jury;
___________________ STATE
_________________ COUNTY
)
) ss:
)
I/we, _________________________, being first duly sworn, declare that the I signed and executed the foregoing
instrument, that I signed it willingly, that it was of his/her free and voluntary act for the purposes expressed in the foregoing
instrument and at the time was 18 or more years of age, of sound mind, and under no constraint or undue influence.
X ___________________________________________________
If this agreement includes both parents or
guardians two signatures will be required
otherwise one signature is sufficient.
X ___________________________________________________
Address: ________________________________________________
NOTARY
_______________ State, ___________________County on this ______ day of ______________ 2015 before me
_______________________, the subscriber, personally appeared ____________________ ___________________ to me
known to be the living (wo)man describe in and who executed the forgoing instrument and sworn before me that they
executed the same as their free will act and deed.
_________________________________________
Notary
7
AT LAW. This phrase is used to point out that a thing is to be done according to the course of the common law; it is distinguished from a proceeding in
equity