Quote:
, (NAME), of (FULL ADDRESS), by my signature affixed to this document, do hereby make the following statement of fact, and affirm:
1. That I was unaware that my application for a social security account number (Form SS-5) was a voluntary act, and that I never needed to disclose or present a social security account number or social security card as a condition for being hired or contracting with any other citizen of the 50 union states of the United States of America;
2. That the Federal government, and particularly the Social Security Administration, does not openly advertise the fact that application for a social security account number is voluntary for citizens of the 50 union states of the United States of America;
3. That due to fact #2 above, the mindset of the business community is erroneously predisposed to believing that it is illegal to hire or do business with people without social security account numbers;
4. That because of the facts #1, #2 and #3 above, I was fraudulently and incorrectly led to believe that I was required by law to apply for a social security account number;
5. That I was of minor age, younger than the legal and lawful age of consent when I completed an application for a social security account number and as a matter of law I am not bound by any act that I committed when younger than the lawful age of consent;
6. That by reason of the aforesaid facts, I do hereby exercise my rights as a free and sovereign citizen of (STATE), upheld by various court decisions to revoke, rescind, cancel and to render null and void, retroactively to the time of signing, based upon the constructive fraud perpetrated upon me by the United States government and the Social Security Administration, the "SOCIAL SECURITY NUMBER" application (From SS-5), made before I became of legal age, which caused a file bearing the identifying number [XXX-XX-XXXX] to be established for myself; that this revocation and rescission is based upon my rights in respect to constructive fraud as established in, but not limited to the cases of Tyler v. Secretary of State, 184 A.2d 101 (1962), and also El Paso Natural Gas Co. v. Kysar Insurance Co., 605 Pacific 2d. 240 (1979) which stated: "Constructive fraud as well as actual fraud may be the basis of cancellation of an instrument."
7. That I do hereby place the Social Security Administration on notice that it is my sincerest desire that all files maintained by the Social Security Administration which are associated with me or reflecting my alleged earnings history be purged;
8. That all social security account records created by the Social Security Administration are the property of the Social Security Administration and not the property of any person that might be described by such records;
9. That due to fact #8 above, I am not authorized to order the Social Security Administration to purge any social security account records that might pertain to myself;
10. That the decision that will be made pursuant to this affidavit, whether or not to purge such file or account number, is a decision that falls solely and fully within the domain and responsibility of the Social Security Administration and that such decision is not my responsibility, and that I am therefore not legally affected or bound by the consequences of this decision;
11. That all social security cards issued by the Social Security Administration are property of the Social Security Administration, as claimed in writing on social security cards, and that social security cards are not the property of the persons to whom they are issued;
12. That social security numbers are more properly called social security account numbers as their proper purpose is to identify accounts maintained by the Social Security Administration;
13. That social security account numbers are intangible abstract entities that cannot be possessed by, adhered or bound to any person in any real, tangible or physical manner.
14. That in light of these aforesaid facts, and revocation contained within fact #6 above, I do not, in the truest sense, possess or have a social security account, and I likewise do not possess or have a social security account number.
15. In order to protect my Right to Life, Liberty and the Pursuit of Happiness secured by the United States Constitution and the Constitution of (STATE), it may from time to time become necessary to amend this affidavit. Wherefore, I do hereby declare that right herein.
I now affix my signature to these affirmations:
