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  • Application For Repatriation and Citizenship

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    This document appears to be an application for repatriation and citizenship with the United States Republic National Headquarters. It requests personal information such as name, contact details, birthdate, education history, employment, and legal background. It also asks applicants to list any skills or trades that could help build the national government. The final sections inquire about any outstanding legal issues, court cases, or other matters that may affect citizenship eligibility.

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    This document appears to be an application for repatriation and citizenship with the United States Republic National Headquarters. It requests personal information such as name, contact details, birthdate, education history, employment, and legal background. It also asks applicants to list any skills or trades that could help build the national government. The final sections inquire about any outstanding legal issues, court cases, or other matters that may affect citizenship eligibility.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    84 views4 pages

    Application For Repatriation and Citizenship

    Uploaded by

    Master
    This document appears to be an application for repatriation and citizenship with the United States Republic National Headquarters. It requests personal information such as name, contact details, birthdate, education history, employment, and legal background. It also asks applicants to list any skills or trades that could help build the national government. The final sections inquire about any outstanding legal issues, court cases, or other matters that may affect citizenship eligibility.

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    © All Rights Reserved
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    of 4

    UNITED STATES OF AMERICA REPUBLIC

    NATIONAL HEADQUARTERS
    P.O. BOX 436885
    CHICAGO, PROVINCE OF ILLINOIS [60643]
    PHONE: 773-359-3192
    www.unitedstatesrepublic.us
    EMAIL: [email protected]

    “To Uplift Fallen Humanity”


    APPLICATION FOR REPATRIATION AND CITIZENSHIP
    * ATTENTION* 1. NATIONALIZATION PROCESSING FEE (Nationality is Free)
    2. MUST TAKE BOTH, Nationalism and citizenship Course (donation requested)
    (required to be completed within three (3) months and prior to participation in any Nationalization Ceremony)
    Please include Certified Birth Certificate, color copy (front & back) Social Security Card, Driver’s License.
    Two Passport Photos, and a copy of any existing name change (court order or county recorder filing)
    All names used are to be printed as “AKA” on your In-Take Form. “PLEASE PRINT”

    Appellation/Name:
    FIRST NAME MIDDLE NAME LAST NAME. TITLE

    NAME AT DELIVERY:
    FIRST NAME MIDDLE NAME LAST NAME

    CURRENT NAME USED:


    (Paperwork to substantiate change MUST be included) i.e. Court Order, etc…

    MAIDEN NAME: (if any)

    DOMICILE:
    CITY / STATE / ZIP

    MAILING LOCATION:
    CITY / STATE / ZIP

    TELEPHONE:
    Home Business Mobile

    EMAIL:

    APPLICANT’S AUTOGRAPH/SIGNATURE DATE

    VITAL DATA
    1. Race: Nationality:

    2. Social Security No.: Front: Back:

    3. Driver’s License No.: State: Exp. Date:

    4. Born Date: Born Time: Born Country:

    Born City: Born State: Born County:

    5. Sex: Age: HT: WT: Hair Color: Eye Color: Blood Type:

    USRAP 041504, 29 August 2018 (AD) Supersedes all previous Form 001 page 1 of 4
    APPLICATION FOR CITIZENSHIP

    1. High School: Start Date: End Date:

    Graduation Date: GED Date:

    Type Diploma/Degree:

    Name of High School: Address: City/State/Zip

    2. College/University: Start Date: End Date:

    Graduation Date: GED Date:

    Type Diploma/Degree:

    Name of College/University: Address: City/State/Zip


    3. Trade School: Start Date: End Date:

    Graduation Date: GED Date:

    Certification/Degree:

    Name of Trade School: Address: City/State/Zip


    Additional Info:

    EMPLOYMENT / VITEA

    Employment:

    Address:

    City/State/Zip:

    Phone: Supervisor’s Name:

    Start Date: End Date: Length Employed (Yrs/Mons)

    Salary: Position Description:

    EMERGENCY CONTACT INFORMATION

    Name:

    Location: City/State:

    Relationship: Phone Number:


    USRAP 041504, 29 August 2018 (AD) Supersedes all previous Form 001 page 2 of 4
    APPLICATION FOR CITIZENSHIP

    ACHIEVEMENTS, AWARDS, CERTIFICATIONS, FELLOWSHIPS, HONORS, LICENSES, AND RECOGNITIONS

    1. Date:

    2. Date:

    3. Date:

    4. Date:

    5. Date:

    6. Date:

    7. Date:

    8. Date:

    9. Date:

    As a NATIONAL /Citizen OF THIS NATION, WHAT SKILLS DO YOU HAVE THAT YOU FEEL WILL BE
    HELPFUL IN BUILDING OUR NATION AND NATIONAL GOVERNMENT:

    TRADE/BUSINESS

    Trade/Business Name:

    Address:

    City/State:

    Position/Role:

    Website:

    Email:

    Product(s)/Service(s):
    Use back of this page for any additional information:

    USRAP 041504, 29 August 2018 (AD) Supersedes all previous Form 001 page 3 of 4
    BACKGROUND LEGAL
    INFORMATION
    Do you have any outstanding legal issues? (Felonies/Misdemeanors or Warrants or Tax Issues):

    Please list any outstanding Traffic Citations or Outstanding Fines/Penalties:

    Do you have any current Court Action(s) pending?

    Do you have a current/valid Driver’s License? If so, which State? If not, please explain

    Have you been convicted of any crimes other than traffic violations? If so, please explain

    Are there any other legal issues that you care to discuss?

    Please be aware that the government cannot provide any legal advice for cases older than 30 days.

    Ready, Set, Go! Nation-Build!!!

    USRAP 041504, 29 August 2018 (AD) Supersedes all previous Form 001 page 4 of 4

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