JONN HENRY DOE,

)
PETITIONER, ) THE MARION SUPERIOR COURT,
)
V ) CRIMINAL DIVISION, COURT XXX
)
STATE OF INDIANA )
)
)
COUNTY OF MARION
) Case No.: 49XXX-XXXX-XX-XXXXXX
)
CITY OF INDIANAPOLIS,
AND ALL ASSOCIATED CASE
RESPONDANT, NO. WITH THIS MATTER

AFFIDAVIT OF FACT AND SURENDER OF THE ALLEDGE DEFENDANT/LEGAL

PERSON/LEGAL ENTITY “JONN HENRY DOE”

Petitioner John Henry of the family Doe; as a self aware living man hereby (affirm) that I am not

JONN HENRY DOE, it is a “fictitious entity” I declare that I am John Henry of the family Doe a

Sovereign living and breathing man and not the LEGAL ENTITY/LEGAL FICTION/LEGAL PERSON

“JONN HENRY DOE”. I John Henry of the family Doe the living man on the land herby surrender the

LEGAL ENTITY “JONN DOE”, “JONN H DOE” and or “JONN HENRY DOE” by way of a CERTIFIED

COPY of “CERTIFICATE OF BIRTH” CERTIFICATE NO/FILE NO. XXXXXXX, XXXXXXXX and or

XXXXXXXXX to this court in order to satisfy this matter, as well as satisfy the warrant for “JONN

HENRY DOE” which a certified copy is hereby attached.

Petitioner John Henry of the family Doe hereby demands that the COURT and or Presiding JUDGE

remove any so called warrant for the living man John Henry of the family Doe.
The Foregoing Instrument is being executed under the hand and seal of the self aware living

man and is my free-will act and Deed. So help me God.

Respectfully Submitted:
Self aware living man by Special appearance.

ACKNOWLEDGEMENT OF WITNESSES

State Indiana )
) SS ACKNOWLEDGEMENT
Marion County )

Personally appeared John Henry-Doe & John Henry-Doe #2 known to me (or proved to me on the basis of
satisfactory evidence of identification) to be the living men whose names is subscribed upon these instrument(s)
and acknowledged to me that they executed the same in their authorized capacity; and by their signature on this
instrument, as their freewill act and deed.

Subscribed and affirmed before We, the below signed witnesses on the ______Day of July 2012.

Witness 1:____________________________________________Print:______________________________________Date:____________

Witness 2:____________________________________________Print:______________________________________Date:____________

Witness 3:____________________________________________Print:______________________________________Date:____________

Witness 4:____________________________________________Print:______________________________________Date:____________