Moorish America National Affairs

Allodial American National Identification Card application

Free National Appellation___________________________________________________ (as to be on ID)

c/o Mailing Location: _____________________________________________________

City: _________________________________ State: ____________________

Indigenous Name of State if any known(Ex:Texas - Tejas)[Zip]: _____________

Natural Born Day: ______________________ Height: ________ Weight: __________

Sex: ______________

Email / Phone: ___________________

Please Provide:

1. Autograph in Red only (bottom)

2. Right Thumbprint in red (bottom)

3. Passport style Photo(solid white background)

4. Copy of state ID (proof of the fraud status imposed upon you)/other Moorish Nationality Card

Submit this form via email to:

E-Mail: walterbey7moor@gmail.com - Scanned PDF

Note: This form must be submitted along with PayPal payment, as you must provide autograph
thumbprint and passport style photo, all of which can be emailed (Scan Copy not picture) or mailed.
PayPal orders are identified by email address used to establish order. If paid via PayPal, please indicate
email address.

Autograph in box R: THUMB IN BOX