Vaccine Contraindication Exemption

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TRIBAL MEDICAL CONTRAINDICATION TO VACCINATION

Indigenous Rights Protections


Indigenous Political Authority © ®
Xi-Amaru Tribal Government © ®

This is to certify that the following is a true Political Status: Indigenous


Record filed with the Indigenous Political Authority Contact: Aboriginal Medical Association
US Dept of State Federal Authentication # 06013144-1, 3900 Crown Road SW Suite 162656
Atlanta, Georgia 30321
State & County level. www.indigenouspoliticalauthority.org
www.aboriginalmedicalassociation.com

_______________ ___________________________________
Date of Issue Adult/Childs Appellation/Name

This recorded document is in harmony with International law for exemption rights and indigenous protections for
children and adults.

It is consistent with International Law, The Constitution of the IPA, ARNA-Xi Amaru Tribal Government, The
Universal Declaration of Human Rights, The United Nations Declaration of the Rights of Indigenous Peoples,
International Treaties and Tribal Medical exemptions from vaccinations. Forced Vaccinations are an ACT OF
GENOCIDE [See USC 18 section 1091] against Peoples allergic to their contents and who can have short term and
long-term adverse impact due to the vaccination.

Any institution, municipality, county, borough, parish, state, federal agency or nation state that attempts to
require any vaccinations or other medical procedure by force upon Indigenous peoples in respect to Indigenous
Peoples are acting under color of authority and in threat, duress and coercion of the Indigenous person(s)
involved. Such acts require review of Tribal Medical officials and proper legal representation of the
indigenous person involved. All Indigenous Peoples of the Indigenous Political Authority, ARNA – Xi Amaru
Tribal Government have a natural, personal and political right not to participate in genocidal acts attempted
against their person, their Aboriginal Tribal nation and they cannot legally be forced by any nation states or
private parties to participate in ANY MEDICAL PRACTICE that is AGAINST their life and general health Standards
and Tribal & International Rights. All Indigenous Peoples of the Indigenous Political Authority ARNA-Xi Amaru
Tribal Government reserve the right to have their own CERTIFIED Health Professionals to conduct all Medical
diagnostics, procedures and Health related Services for Indigenous Peoples.

LIABILITY CLAUSE:
THE AFFIANT assumes full liability for the lack of taking the vaccine to enter into any country.

Indigenous Political Authority - U.S. Department of State Federal Authentication # Status A-1 06013144-1
Full Name of Adult:
Date of Birth: Hour: Sex:
Race: [Aboriginal]
Mailing Location: Born in State: County-City:
Zip: Nationality: Indigenous American
Tribal lineage: Xi
Full Name of child: Age at Full Name of child: Age at time:
time:
Full Name of child: Age at Full Name of child: Age at time:
time:
I, _______________________________________________
Have hereunto set my Signature.

County ____________________ State ___________________________

Sworn and Subscribed before me___________________________________ this [day] ________


[month] _________ [year]________

Notary Signature_____________________________

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