The United Nuwaupian Nation’s Tribal Ledger  

From: the Executive Office of Paa Mumkak: Khamam “Bananu” A’aqab, Chief Black “Thunderbird” Eagle, Constitutionally Seated President and Head of the State of Nuwaupia, The United

Nuwaupian Nation of the Yamassee Native American, Creek, Seminole, Shushuni, Washitaw, Mound Builders No.215-1993 No.208-1999

Sovereign Grand Commander H. E. Dr. Malachi Z. K. York-EL 33°/720° Declaring Independence to The World on June 26th 1992 A.D.

I, ____________________________________, As a National and Tribal member Of The Yamassee Native American Creek, Seminole, Washitaw, Mound Builders, the United Nuwaupian Nation, Do Hereby Acknowledge, Agree With And Accept As The Full Authority And Instrument Of Our Nation’s 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” A’aqab, Chief Black “Thunderbird” Eagle, aka H.E. Dr. Malachi Z. K. York-El, as My Maku/Mico (Chief), Our Constitutionally Seated President And Head Of the State of Nuwaupia, The United Nuwaupian Nation of Yamassee, Creek, Seminole, Shushuni, Washitaw, Mound builders. I Hereby Affirm That The Information Below Regarding Myself Is 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 and Seal of an Official Notary of The United Nuwaupian Nation Official Tribal Seal of the Yamassee Native American, Creek, Seminole, Shushuni, Washitaw Mound Builders.