INTRODUCTION:

You as the owner of yourself are the only one who can change or affect the civil statutory status of your property. This is exhaustively proven in:

Your Exclusive Right to Declare or Establish Your Civil Status, Form #13.008
https://sedm.org/Forms/13-SelfFamilyChurchGovnce/RightToDeclStatus.pdf

You can use this template as an attachment to any government form to prevent any and all civil statutory status elections. This sample is adapted from the following article:

Microsoft Copilot: What is a “Ministerial officer”?, SEDM, Question 7
https://sedm.org/microsoft-copilot-what-is-a-ministerial-officer/

For background on how to craft your OWN such statement, see:

Microsoft Copilot: How the Administrative State Makes Your Consent Invisible, FTSIG
https://ftsig.org/microsoft-copilot-how-the-administrative-state-makes-your-consent-invisible/

WHAT MAKES AN RFRA DISCLAIMER STRONG (Legally)

An effective RFRA disclaimer generally does four things clearly and narrowly, without overreaching:

1. Identifies a Sincere Religious Belief

Courts do not evaluate theology, but they do require:

• A clear statement that the belief is religious in nature
• An explanation of how the belief conflicts with the government action

Strong language:

• Describes the belief positively (what is believed), not just negatively (what is rejected)
• Avoids legal jargon masquerading as theology

Weak language:

• Purely legal conclusions (“this violates RFRA”)
• Political or ideological objections framed as religion

2. Connects the Belief to a Substantial Burden

RFRA requires showing that government action:

• Substantially burdens religious exercise

Strong language:

• Explains how the form, status, or requirement forces conduct contrary to belief
• Identifies the specific act being compelled

Weak language:

• Blanket claims that “all civil status elections are invalid”
• Assertions without a causal explanation

3. Avoids Declaring Legal Effects Unilaterally

This is where many RFRA disclaimers fail.

Courts do not accept:

• Self‑executing declarations that “this prevents all civil status elections”
• Statements that purport to nullify statutes or jurisdiction by declaration

Strong language:

• States objection and reservation of rights
• Requests accommodation or exemption
• Preserves claims without asserting automatic legal consequences

Weak language:

• Claims to “void,” “cancel,” or “prevent” statutory effects by notice alone

4. Preserves Remedies Without Threatening Officials

RFRA protects religious exercise; it does not authorize:

• Accusations of criminal conduct
• Threats of liability
• Assertions that officials are committing crimes by processing forms

Strong language:

• Calm, declarative, non‑accusatory
• Focused on accommodation and non‑participation

Weak language:

• Adversarial tone
• Claims of fraud, peonage, or impersonation embedded in the disclaimer

Common Pitfall to Watch For

If the attachment claims that attaching the disclaimer itself “prevents” or “blocks” civil status elections, that is likely overstated.

Courts generally treat RFRA notices as:

• Evidence of belief
• Preservation of objection
• A basis for later accommodation or litigation

They do not treat them as:

• Automatic jurisdictional bars
• Self‑executing exemptions
• Retroactive nullifications of statutory schemes

Bottom Line

The key question is this:

Does the disclaimer preserve religious objection and request accommodation, or does it attempt to unilaterally declare legal outcomes?

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Formal Statement for Attachment to Government Form

(RFRA Accommodation; Factual, Non‑Legal, Non‑Conditional; Incorporating Delegation‑of‑Authority and Self‑Ownership Principles)

Statement of Sincerely Held Religious Beliefs, Delegation of Authority, and Clarification of Factual Assertions

I submit this statement solely to document my sincerely held religious beliefs and to clarify the factual nature of the information I provide on the ___________ Form. This statement does not alter the ________ form, impose conditions on the Recipient, or request that the Recipient modify its statutory duties. It is provided only to ensure that my factual statements are understood in a manner consistent with my religious convictions and the Religious Freedom Restoration Act (RFRA), 42 U.S.C. §2000bb.

I. Delegation of Authority and Self‑Ownership

According to my faith, all authority originates from God, and Scripture constitutes my delegation of authority order. Biblical korban mandates this.

Korban – Wikipedia
https://en.wikipedia.org/wiki/Korban

As a believer, I am obligated to act only within the scope of that delegation. This includes the duty to maintain the integrity of my identity, to avoid compelled civil associations, to refrain from adopting civil statutory statuses that conflict with my religious obligations, and to respect God’s absolute PRIVATE ownership over the possessions entrusted to me as His trustee. This is exhaustively explained in:

Delegation of Authority Order from God to Christians, Form #13.007
https://sedm.org/Forms/13-SelfFamilyChurchGovnce/DelOfAuthority.pdf

My religious convictions also require that I exercise self‑ownership in the classical sense: the right to control the use of my person, name, and identity, including the right to exclude myself from civil statutory classifications that imply consent, membership, allegiance, or franchise participation. These beliefs govern my personal conduct but are not intended to restrict the Recipient in the performance of its administrative responsibilities.

II. Clarification of Factual Assertions (No Legal Conclusions)

Any statement I make under penalty of perjury on the ____ Form is intended to attest only to historical facts within my personal knowledge (such as place of birth, parentage, physical abode (not residence), or identity markers). My attestation does not constitute, and is not intended to be construed as, an affirmation, adoption, or voluntary acceptance of any legal status, statutory classification, civil membership, privilege, benefit, or obligation that may be associated with those facts by operation of law. I do not possess the authority or competence to swear to legal conclusions, statutory meanings, or civil status determinations, and my perjury statement is not offered for that purpose. This limitation on the scope of my perjury attestation is required by my sincerely held religious beliefs and is asserted pursuant to the Religious Freedom Restoration Act, 42 U.S.C. § 2000bb, to avoid compelled affirmation of civil statutory statuses that conflict with those beliefs.

My statements under penalty of perjury therefore apply only to facts verifiable with third parties, such as:

1. My place of birth
2. My parentage
3. My historical life events
4. My mailing address
5. My phone number
6. My email address
7. My physical characteristics

I do not and cannot swear under penalty of perjury to compelled legal conclusions, statutory meanings, or civil or political statutory classifications, as these are matters of law, not fact, and are outside my delegated religious authority and personal competence.

This clarification is necessary to avoid conflict with my sincerely held religious beliefs and to ensure that my factual statements are not misconstrued as voluntary civil or political associations or legal interpretations.

III. First Amendment Considerations

My only CIVIL lawgiver is God and not any secular government. Isaiah 33:22. Ezekial 20:10-20. Any other approach we dethrone God as “the MOST high” that He calls Himself. This requirement is also the origin of the legal separation between church and state advocated by Thomas Jefferson. Scripture says my BODY is a Temple and therefore a church. 1 Cor. 3:17. My religious convictions for sanctification therefore prohibit me from voluntarily adopting civil statutory statuses or associations with any government or agent of any government fulfilling any civil statutory obligation. The First Amendment protects my right to refrain from compelled speech and compelled association protects my First Amendment rights in the context of all civil legal matters.

Therefore, any factual information I provide or that is validated by the perjury statement provided is not intended to express or imply that any of the following information is factual or actionable in any way:

1. Civil statutory membership.
2. Civil franchise or benefit participation.
3. Civil allegiance (such as 22 U.S.C. 212). I can describe my allegiance at BIRTH under 8 U.S.C. 1401 or the Fourteenth Amendment, but not AFTERWARD, because I can’t be compelled to have it NOW.
4. Acceptance of any civil statutory status beyond the factual circumstances indicated in Section II above.
5. Acceptance of any benefit, privilege, or special rightPUB.
6. Any equivocation or confusion between PRIVATE and PUBLIC, such as:
   6.1. Any voluntary connection between POLITICAL status and CIVIL status as used by the U.S. Supreme Court in U.S. v. Wong Kim Ark, 169 U.S. 649 (1898). The two must NEVER be equivocated.
   6.2. Any voluntary connection between POLITICAL citizen* and CIVIL/DOMICILED citizen**+D. The two must NEVER be equivocated.

This statement is not intended to limit the Recipient’s interpretation of the _______ form; it is intended only to clarify that no form of civil statutory status or civil statutory participation may be implicated, inferred, presumed, or rendered actionable by the Recipient or his employer by virtue of:

1. My selection of form (such as a resident v. nonresident status).
2. Any word or civil statutory status printed on the form by the government creator of the form
3. Any indication of “resident”, “citizen”, “person”, ‘individual”, “taxpayer”, “effectively connected”, government identifying numbers such as SSN or TIN, etc. and similar civil status words.

I cannot rely on government‑supplied labels or statements as a basis for forming legal belief or intent, and therefore I limit my perjury attestation to historical facts only. I say this only because I cannot accept these sources as a legally actionable basis for belief or intent in submitting this form. I cannot vouch for or agree to legal meanings or consequences, only for historical facts within my knowledge.

Notice that I am not MODIFYING what the GOVERNMENT printed on the form, nor defining or redefining anything the government printed on the form. It is impossible to even FILL OUT a government form without adding to and therefore modifying it. As long as what is printed on the form by the government does not have a civil legal consequence or obligation to me or relates only to POLITICAL status and not CIVIL status, I don’t mind validating that with the perjury statement. Everything else is for internal government use only and may impair or affect my private rights or private property, which are God’s absolutely owned property. All rights reserved. U.C.C. 1-308.

IV. Request for RFRA Accommodation

Consistent with Religious Freedom Restoration Act (RFRA), 42 U.S.C. §2000bb and the Recipient or government’s published guidance on religious accommodations, I respectfully request that my application be processed without requiring me to provide or use a Social Security Number or any similar civil identifying number. My religious beliefs prohibit me from using such numbers because they function as civil franchise identifiers and imply civil statutory participation. This is documented in:

1. Mark of the Beast, Form #17.109
   https://sedm.org/Forms/17-Theology/MarkOfTheBeast.pdf
2. Social Security: Mark of the Beast, Form #11.407
   http://famguardian.org/Publications/SocialSecurity/TOC.htm

I am fully willing to cooperate with any alternative identity‑verification procedures the Recipient considers appropriate. This request is not intended to limit the Recipient’s authority or operations, but only to avoid conflict with my sincerely held religious beliefs, my intentions, or any implication of consent or association, whether legal or social. I am NOT empowered as a ministerial agent and trustee of God under the Bible as a trust indenture to transfer or encumber any aspect of the propertyPRI that God owns, which includes me and the entire Earth and the Heavens, according to Gen. 4:19, Gen 14:22, Psalm 24:1, Psalm 89:11, and Psalm 115:16.

Any attempt to change my status or that of the private propertyPRI I am trustee over under God’s delegation order shall be interpreted by me as:

1. A direct interference with my religious practice as God’s trustee.
2. An interference with my right to contract, because trusts are contracts.
3. Theft of religious property, where the civil obligations as propertyPUB which attach to any involuntary civil status are the property stolen.
4. Misrepresentation of my status.

V. No Conditions Imposed on the Recipient

Nothing in this statement is intended or may be construed to:

1. Modify the ___________ Form
2. Impose obligations or limitations on the Recipient of this form
3. Restrict the Recipient’s statutory interpretation of facts and not statuses
4. Alter the legal meaning of any term on the _______ Form because no civil or legal meaning other than mere facts may be construed from the submitted form
5. Limit the Recipient’s ability to verify identity or the facts provided

This statement is provided solely to clarify the factual nature of information but not assertions provided and to document my religious beliefs for RFRA purposes.

VI. Conclusion

All statements I provide here are factual in nature and made under penalty of perjury only to the extent they describe historical events, not legal conclusions or civil statutory statuses. I respectfully request that the Recipient process my form or application in a manner consistent with RFRA and the least restrictive means of furthering any compelling governmental interest.

Thank you for your consideration.