The United Nuwaupian Nation Tribal Ledger From The Office of The United Nuwaupian Nation Maku/Mico H.E.

Dr. Malachi Z. K. York

I, ____________________________________, As A Member And National Of The United Nuwaupian Nation, Do Hereby Acknowledge, Agree With And Accept As The Full Authority And Instrument Of Our Nations Law, All The Contents Of The Constitution Of The United Nuwaupian Nation Since Its Implementation on June 26th 1992 A.D. I Have Accepted Since That Date And/Or Upon The Day Of My Acknowledgement If That Day Was Thereafter Its Implementation, And Still Accept Today Upon My Signature, Paa Mumkak: Khamam Bananu aqab, Chief Black Thunderbird Eagle, aka H.E. Dr. Malachi Z. K. York, as My Maku/Mico (Chief), Our Constitutionally Seated President And Head Of State of The United Nuwaupian Nation. I Hereby Affirm That The Information Below Regarding Myself As Factual: Nuwaupian Name: ________________________________________________________ Current Address: _________________________________________________________ Date of Birth: ____________________________________________________________ _________________________________________ Signature of Affiant This Form Must Be Notarized After It Has Been Completed Sworn To Before Me This ______Day of _____, 20_____ _____________________________ Signature of Notary Public