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Greetings Sheriff Vemon Betts, to All public officials, public government agents, employees

etc, notice; knowledge U.C.C. 5 1-202.

I Sionya HaleyOrM now known as Priya Sha el'me'elOrM lndigenous autochthons Flesh and
Blood Woman, White and American Indian Cherokee Moor and I Michael Fullilove now known
as Marshawn Shiloh Wijaya Sha ul me el lndigenous autochthons Flesh and Blood Man, White
and American Indian Cherokee Moor of Cahokia, Atlan, Turtle Island and on behalf of our
Children Etheryah Selene Haley now known as Aleshanee Kerensa Sha ul me el lndigenous
Autochthonous flesh and blood female child and Michael Fulliove now known as Samon Wrjaya
Sha ul me el Indigenous flesh in blood male child. We give notice; knowledge U.C.C. 5 t-2O2,
Tit\e 42 U.S.C. $ 1986 of our Indigenous Standing As well as our race and ethnicity is White
and American lndian via our SFl8l this is in harmony with House Joint resolutianl94, S con res
26, Presidential proclamation 7500, Executive order 13107 and congressional record pages
A3220 May 11, 1955 lnternational Covent on civil and political rights, International Covent on
economic social and culture rights, United Nations Declaration on tlie rights on lndigenous
People Article 2,3,4, and 33 which guaranteed our rights to self determination and self identiff
without discrimination.. This notice was Tender Honorably to the Govemor Jay Nixon, Elizabeth
1l Pope Francis I president Obama Yaticanl Holy See which is accord with international law...

Cc: Pope Francis


Cc: Governor Eric Greitens

Please update and forwmd(fax) this information to St.Louis Police Dep*rtment Central Patrol,
Metropolitan Police Department St.Louis Police Department North Patrol, St.Louis Police
Department South Patrol . Please update our Race and ethnicity in your computer data base to White
and American Indian, If only one option is available white race is preferred.....This information will be
posted on internet for publish Notice, Thank you! ! In the great spirit of our Ancestors.....

Jurat
United Nations Declaration on the right of Indigenous Peoples-
(!:.:.-tp. ,,":,rff::.!i1t.i.llJ--!Llljliq-.!L1j11:{-'j-,iji.j-{j.iill-!jt!Jl-i{L-q ==g.q.1'da} United
Nations Convention on
Economic, Social & cultural Rights, United Nations Charter; Article 55 & 56, Presidential
proclamation 7500,H.J.R. 194, S. Con. Res. 26 S. 1200, HJR-3
;.) -,.',-'i"Y
Attrmed to and subscribed betbre me this ) day of Jufle 2017
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By:
Affiant
X Prodrr"e Identification Type aad + rp l.n;,:'":r, i\o"D,;.,,o- L}.-t ill bber
Notary
- Public My Commission Expires
TifiiorHY J MovvRY
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Commissioned for St' Louis County
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Greetings Chief Colonel Jon Belmar, to All public officials, public government agents,
employees etc, notice; knowledge U.C.C. $ 1-202.

I Sionya HaleyOrM now known as Priya Sha el'me'elOrM Indigenous autochthons Flesh and
Blood Woman, White and American Indian Cherokee Moor and I Michael Fullilove now known
as Marshawn Shiloh Wijaya Sha ul me el Indigenous autochthons Flesh and Blood Man, White
and American Indian Cherokee Moor of Cahokia Atlan Turtle Island and on behalf of our
Children Etheryah selene Haley now known as Aleshanee Kerensa Sha ul me el Indigenous
Autochthonous flesh and blood female child and Michael Fulliove now known as Samon Wrjaya
Sha ul me el Indigenous flesh in blood male child. We give notice; knowledge U.C.C. $ 1-202,
Title 42 U.S.C.$ 1986 of our Indigenous Standing As well as our race and ethnicity is White and
American Indian via our SF181 this is in harmony with House Joint resolution 194 S con res 26
Presidential proclamation 7500 Executive order 13107 congressional record pages A3220 May
1 1, 1955 International Covent on civil and political rights, International Covent on economic

social and culture rights, United Nations Declaration on the rights on Indigenous People Article
2,3, 4, and 33 which guaranteed our rights to self determination and self identify without
discrimination.. This notice was Tender Honorably to the Governor Jay Nixon, Elizabeth ll Pope
Francis I president Obama Yatican/ Holy See which is accord with intemational lar,l,...

Cc: Pope Francis


Cc: Governor Eric Greitens

Please update and forward (fax) this information to 1 precinct North County,2 Precinct Central, 3
Precinct Affton Southwest, 4 Precinct South County, 5 Precinct City of Fenton, 6 Precinct City of
Wildwood, 7 Precinct West county, 8 Precinct City of Jennings. Please update our Race and ethniciry-
in your computer data base to White and Arnerican [ndian, If only one option is available white race is
preferred..... This infomation will be posted on internet for publish Notice, Thank you for your time ...
In the great spirits of our Ancestors.....

Jurat
tlnited Nations Declaration on the right of Indigenous Peoples-

Economic, Social & cultural Rights, United Nations Charter; Article 55 & 56, Presidential
proclamation 7500,H.J.R. 194, S. Con. Res. 26 S. 1200. HJR-3

Affrrmed to and subscribed before me this ::auy of July 2017


Ar**m:d nprsvtlql*-,
r$ itt,\
By:
Alfiant U ,ut prejudice
* Produce Identification Type and # ID ,' A)crl * jv 1- L. t C, utu*

J, MOWRY
Notarv Public - NotarY Seal
-TIMOTHY
srArr or MlssouRl
Commissioned for St. Louis CountY
Mv Commission Expires: April 8 2019
Commission # 15634648
TRAN5I.,II55]EI{ UERIFICATII]N REPIRT
TIt',lE E3/28/2813 82:35
I.{AT4E UP5
EA\/ 9627248
TEL
SEE. # u63274J5J1 451 4E

DATE, T]IVIE E3/28 E2:34


FAH HO. /NAF{E 31 481 57885
DURATION EB: El- : l- 2
PAGE(5} E5
RESULT OH
IvII]DE STANDARD
ECM
U S. Otftce of Personnei Management ETHNICITY AND RACE IDENTIFICATION
Guide to Personnel Data Standards (Please read the Privacy Act statement and instructions before completing form.)
Name (Last. First, Micidle lnitial) Social Security Number Birthdate (Month and year)

Agency Use Only


ii

Privacy Act Statement

Eihnicity and race information is requested under the authority of 42 U.S.C. Section 2000e-16 and in
compliance with
the.Ojfice of Management and Budgefs 1997 Revisions to the Standards for the Classification of Federal
Data on Race
and Ethnicity- Providing this information is voluntary and has no impact on your empfoyment
status, but in the instance
of missing information, your employing agency will aftempt to identify your race and ethnicity by visuai observation.

This information is used as necessary to plan f9r equal employment opportunity throughout the Federal government.
lt
is .?qo use! by the U. S- office of Personnel Managemint:'or empioying agency ,i"int*ring the rejords to tocate
individuals for personnel research or survey response and in *re procuitioi of summary descriptive
statistics and
analytical studies in support of the function for which the records are coilected and maintainld;;; d';;l"t"d',.iormor."
studies.

Social Security Number (SSN) is requested under the authority of Executive Order g3g7, which
requires SSN be used
for the purpose of uniform, orderty administration of personnel iecords. Providing
this information is voluntary and failure
to do so will have no effect on your employment status. tf ssN is not provided,-however,
other agency sources may be
used to obtain it.

Specificlnstruetions:ThetwoqUBtionsbelowaredesignedtoio
guestion 1, go to question 2.
Question1.AreYouHispanicorLatino?(ApersonofCuban,r.,r"*
Spanish culture or origin, regardtess of race.)

Question2,Pleaseselecttheracialcategoryorcategorieswithwhichyoumostcloselyidentifyovffi
box. Check as many as apply.
RACIAL CATEGORY
(Clggir as many as appty) DEFINITION OF CATEGORY
lndian or Alaska Native
{ qersgn having origins in agy of the original peoples of North and south America
{including centrat America), and who maintains tribal affifiation or community
attachment.
A person having origins in any of the original peoples of the Far East, southeast
Asia, oi- the indian subcontinent incrudin!, for'exampre, cambodia, C'hina, india
Japan, Korea, Malaysia, pakistan. the phirippine rsrands, Thailand, vi"tn"*.
"ni
Black or African American A person having origins in any of the black racial groups of Africa.

Native Hayraiian or Other pacific islander A.person having origins in any of the originar peopres of Hau;aii, Guam. samoa,
other Pacific lslands,
ir
White A person having origins in any of the original peoples of Eurooe. the Middle
East. or
North Africa. \

Standard Form 181


Revised August 2005
Previous editions not usable

42 U.S.C. Section 2000e-16


1.'

':-

U.S. Office of Personnel Management ETHNICITY AND RACE IDENTEFICATION


Guide to Personnel Data Standards (Please read the Privacy Act statement and instructions beiore completing form.)

Name (Last, First, Middle lnitial) Social Security Number Birthdate (Month and Year)

I\Auerr
Agency Use dnly
E-r Arttqu S ffi b;t rn*rer J,iia

Prlvacy Act Statement

Ethnicity and race information is requested under the authority of 42 U.S.C. Section 2000e-16 and in compliance wiih
the Office of Management and Budget's 1997 Revisions to the Standards for the Classffication of Federal Data on Race
and Ethnicity. Providing this information is voluntary and has no impact on your employment status, but in the instance
of missing information, your employing agency will attempt to identify your race and ethnicity by visual observation

This information is used as necessary to plan for equal employment opportunity throughout the Federal governmeni. lt
is also used by the U. S. Ofiice of Personnel Management or employing agency maintaining the records to locaie
individuals for personnel research or survey response and in the production of summary descriptive statistics and
analytical studies in support of the function for which the records are collected and maintained, or for related workforce
studies.

Social Security Number (SSN) is requested under the authority of Executive Order 9397, which requires SSN be used
for the purpose of uniform, orderly administration of personnel records. Providing this information is voluntary and failure
to do so will have no effect on your employment status. lf SSN is not provided, however, other agency sources may be
used to obtain it.

Specific lnstructions: The two questions below are designed to identify your ethnicity and race. Regardless of your answer to
question 1, go to question 2.
Question 1. Are You Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other
Spanish culture or origig, regardless of race.)
CIYes R ryo
Cluestion 2.Please select the racial calegory or categories with whictr you mosl closely identify by placing an "X' in the appropriate
box Check as many as apply.
RACIAL CATEGORY
(Check as many as apply) DEFINITION OF CATEGORY

lndian orAlaska Native A person having origins in any of lhe original peoples of North and South America
ft$mertcan (including Central America), and who maintains tribal affiliation or communitv
attac+lment.

f| Rsian A person tiaving origins in any of the original peoples of the Far East, Southeast
Asia, or the lndian subcontinenl including, for example, Cambodia, China, lndia,
Japan, Korea, Malaysia, Pakistan, the Philippiire lslands, Thailand. and Vietnam-

0 Alacf orAfrican American A person having origins in any of the blaci< racial groups of Africa.

I ttative Hawaiian or Other Pacific lslander A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or
other Pacifrc lslands.

fo\,wtrite A person having origins in any of the original peoples of Europe, the Middle Eabt, or
North Africa.

Standard Form 181


Revised Augusi 2005
Previous editions not usable

42 U.S.C. Seciion 2000e-16

NSN 7540{1-09S-344e
3k
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\Q
\b
U.S. Cfflce of Personnel Management ETHNICITY AND RACE IDENTIFICATION
Gui i: to Personnel Data Standards (Please read the Privacy Act Statement and instructions before completing form.)

Name Last, First, Middle lnitial) sociarsecuri(lftr,dddt Il PH 3: pltnaate (Month and year)

Apusl 5ot((A M
Agenc, Use ohly
W rll\,1 ):, ',1 fit
tL:i,.-:1.,,,
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..
... "l
iYrnwrv \Wg

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Privaty Act Statement

Ethnicty and race information is requested under the author'lty of 42 U.S C. Section 2000e-16 and in compliance with
the Olice of Management and Budget's '1 997 Revisions to the Standards for the Classification of Federal Data on Race
and Providing this information is voluntary and has no impact on your emplorrment status, but in the instance
=ihnicity.
of mising information, your employing agency will attempt to identify your race and ethnicity by visual observation.

This information is used as necessary to plan for egual employment opporlunity throughout the Federal government. lt
is also used by the U. S. Office of Personnel Management or employing agency maintaining the records to locate
indivicuals for personnel research or survey response and in the production of summary descriptive statistics and
analf,cal studies in support of the function for which the records are collected and maintained, or for related workforce
studies.

Social Security Number (SSN) is requested under the authority of Executive Order 9397,'which requires SSN be used
for the purpose of uniform, orderly admrnistr-ation of personnel records. Providing this information is voluntaq,and failure
to do so will have no elfect on your employment status. lf SSN is not provided, however, other agency sources may be
used 1c obtain it.

Speciic lnstructions: The two questions below are designed io identify your ethnicity and race. Regardidss dygur afrwer to
question 1, go to question 2. . --: .al: j F
Question 1.
Are You Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central Ameiican, cE6ther
Span ish culture or origin, regardless of race.) , ., l
SYes BNo ro
Question 2. Please select the racial calegory or categories with which you most closely identify by placing an "X" in tffuppropriate
box. Check as many as apply.
RACIAL CATEGORY
DEFINiTION OF CATEGORY (*,
(Check as many as apply) gr
lndian orAlaska Native A person having origins in any of the original peoples of North and South America
(including Cenlral America), and who maintains tribal affiliation or community
attachnEnt.
A person having origins in any of the original peoples of the Far East, Southeast
Asia, or the lndian subcontinent including, for example, Cambodia, Ghina, lndia,
Japan, Korea, Malaysia, Pakistan, the Philippine lslands, Thailand, and Vietnam.

J Black orAfrican American A person having origins in any of the black racial groups of Africa.

f Natlve Hawaiian or Other Pacific lslander A person having origins in any of thq original peoples of Hawaii, Guam, Samoa, or
other Pacific lslands.

$wni,u A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa.

Standard Form 'l81


Revised August 2005
Previous editions not usable

42 U.S.C. Section 2000e-16

NSN 7540{1-099-3446
srqw-:sl$>
:.f;1:>)}:>)'l]l\\N)
c!>:s-''--x')D
S*
tL\,-}}-Cl,l,l35 i - Dr
U.S. Office of Perscnnel Management ETHN IDENTIFICATION
Guide to Personnel Data Stanciards (Piease read the Pnvacy Aottatemeirt,and instruciions before completing form.)

Name (Last, First, l;'liddle lnitial) Sociai Sea:riiY +$irnber -'' Birthciate (Month and Year)

FULLILOVE,MICHAEL,A 0211976
Agency Use Only

Privacy Act Statement


F t,.=,:ru
Ethnicity and race information is requested under the a 2000e-16 and in compliance
with the Office of Management and Budget's 1997 Revigigns n Classification of Federal
Data on Race and Ethnicity. Providing this information is TolffiTaTI-EIChEs no on your employment
status, but in the instance of missing information, your employing agency will attempt to identiff your race and
otl-rninifrr hrr rricr ral nlrcanrafinn
L.L.:".v.iJ v j ..vev'

This information is used as necessary to plan for equal employment opportunity throughout ihe Federal
government. lt is also used by the U.S. Office of Personnel Management or employing agency maintaining the
records to locate individuals for personnel research or survey response and in the production of summary
descriptive statistics and analytical studies in support of the function for which the records are collected and
maintained, or for retated worKorce studies.
Social Security Number (SSN) is requested under the authority of Executive Order 9397, which requires SSN be
used for the purpose of uniform, orderly administration of personnel records. Providing this information is
voluntary and failure to do so will have no efiect on your employment status. lf SSN is not provided, however,
other agency sources may be used to obtain it.
Specific lnstructions: The two questions below are designed to irlentify your ethniclty and race. Regardless of your answer to
question 1, go to question 2.
Question 1. Are You Hispanic or Latino? (A person of Cuban. Mexican, Puerto Rican, South or Cenkal American, or other
Spanish culture or origin, regardless of race.)
8v'* [ ruo

Question 2. Please select the racial category or categories with v'trich you most closely identifu by placing an "X" in the appropriate
box. Check as many as apply.
RACIAL CATEGORY
DEFINITION OF CATEGORY
(Check as many as apply)

lfl American tndian or Alaska Native A person having origins in any of the original peoples of Norrh and South America
(induding Central America), and who maintains tribal affiliation or communily
attachment.

Iasian A person having origins in any of the original peoples of the Far Easl, Southeast
Asia, or the lndian subcontinent induding, for example. Cambodia, China, lndia.
Japan, Korea, Mataysia. Pakistan. the Philippine lslands, Thailand, and Vietnam.

f] Stact or Aftican American A person having origins in any of the black racial groups of Africa.

A person having origins in any of the originat peoples of Hawaii, Guam, Samoa, or
f] t'tative Hawaiian or Other Pacific lstander
other Pacific lslands.

ffi wnit" A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa.

Standard Form iBl