Mary Ann Clark©

c/o 1234 Anytown Street

Anytown, State [12345]

March 1, 2023

Antony J. Blinken
United States Secretary of State
U.S. Department of State
2201 C Street, NW
Washington, D.C. 20520

Sent Via USPS Priority Mail – Return Receipt Requested: __________________________________

Notice to Principals is Notice to Agents, Notice to Agents is Notice to Principals

Re: Declaration of Political Status of Mary Ann Clark©

Dear Secretary Blinken:

This letter is to provide you with a copy of my Declaration of Political Status which affirms that I have returned to my lawful
birthright political status as a «Denonym».

Let it be clear that I am neither a Territorial United States Citizen nor a Municipal Citizen of the United States.

I am not a pauper, debtor, rebel, combatant, foreign agent, public dependent, U.S. Citizen, a Municipal citizen of the United States,
or in any way separated from the organic States of the Union.

Thank you for your attention to this matter.

So Autographed and so Sealed this _______ day of «Record_Month» in the year Anno Domini «Record_Year».

Sincerely,

________________________________________________
By: Mary Ann Clark©
All Rights Reserved. Without Prejudice.

Enclosure

Declaration of Political Status Cover Letter – Mary Ann Clark

Page 1 of 1
 Mary Ann Clark©
c/o 1234 Anytown Street
Anytown, State [12345]

March 1, 2023

Rena Bitter
United States Assistant Secretary
U.S. Department of State
Bureau of Consular Affairs
2201 C Street, NW
Washington, D.C. 20520

Sent Via USPS Priority Mail – Return Receipt Requested: _______________________________

Notice to Principals is Notice to Agents, Notice to Agents is Notice to Principals

Re: Declaration of Political Status of Mary Ann Clark©

Dear Assistant Secretary Bitter:

This letter is to provide you with a copy of my Declaration of Political Status which affirms that I have returned to my lawful
birthright political status as a «Denonym».

Let it be clear that I am neither a Territorial United States Citizen nor a Municipal Citizen of the United States.

I am not a pauper, debtor, rebel, combatant, foreign agent, public dependent, U.S. Citizen, a Municipal citizen of the United States, or
in any way separated from the organic States of the Union.

Thank you for your attention to this matter.

So Autographed and so Sealed this _______ day of «Record_Month» in the year Anno Domini «Record_Year».

Sincerely,

________________________________________________
By: Mary Ann Clark©
All Rights Reserved. Without Prejudice.

Enclosure

Declaration of Political Status Cover Letter – Mary Ann Clark

Page 1 of 1