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Appellation Priya Siran EL


38.602177 Latitude -90.206058 Longitude
Turtle Island
Dear Judge: ANNE MARIE CLARKE

Hotep, Sionya Haley now known as Priya Siran El is an Indigenous Autochthonous flesh
and blood Cherokee moor, woman on the Land Cahokia missouria hrrtle Island, Egypt of
the west I DENY any and 411slaims of corporate existence CITIZENSHIP residence
client slave for FRAUD I'm making a special appearance regarding my children Michael
Fullilove now known as Samon Wijaya Sha ul me el and Etheryah Haley now known as
Aleshanee Kerensa Sha ul me el of this matter addressing the court for the kidnapping of
my children and Lack ofjurisdiction.

In accord with U.N. Declaration on the rights of Indigenous peoples. This is the 2nd
decade for the people of African descent you all are suppose to be promoting the
activities for people of African descent which is... JUSTICE DEVEPLOMENT and
RECOGNITION withNOT doing so you all are VIOLATING Intemational Law which
you all are under Lrtemational LAW These documents that I have sent in to the court will
be published on the Intemet for universal knowledge so that you cannot deny having any
knowledge or no knowledge (facebook twitter scrib d) for all to see...
Thank you for your time.. ..In GREAT Spirit of my ancestors UCC 1-308 all rights
reserved without prejudice

CC:

THOMAS KLOEPPINGER

CC:

KATHRYN

I{ERMAN

Rule 8 Under Federal Rule

of Civil Procedure General rule pleading and motions

ln the matter concerning Etheryah Haley now known as Aleshanee Kerensa Sha ul'me'el and

Michael Fullilove now known as Samson Wiyaya Sha ul me'el daughter and son to the
lndigenous Autochthonous Parents of Ani-yu-Wiya Cherokee moor descent Sionya Michelle
Haley Now known as Priya Siran Sha ul me el and MichaelAnthony Fullilove now known as
Marshawn Wijaya Sha ul me ul. ln response to the petition filed by the petitioner KATHRYN

HERMAN. This petition is VOLD for lack of merit Lack of Mutual consideration Lack of Mutual

Benefits Lack of free prior informed consent of the lndigenous Autochthonous Parents and are
fra ud.

Under The authority of federal rules of civil procedure rule 8 the overwhelm evidence of the

intent of the doctors staff agents and officers were to violently in force committing acts of
Genocide by ignoring all laws international and domestic by attacking a innocent woman and
child who saw their help in the time of need this can be demonstrate by the racial profile and
discrimination with the statement about the mother me Sionya Haley now known as Pryia sha
ul me el appearing to be African American which is a factual document which was filed with the
Office of management and Budget identify my race and ethnicity as white and Native American
were blatantly disregarded which should have not been a factory in respect and consideration
of my wishes when administering treatment to my child This was an clearly attack base on
personal races intent ignorance and lack of respect for human rights force integration and
assimilation to destroy the integrity of the rights of the mother and my child where aggressively
impose with medical experimentation and lack of free prior informed consent with the dawning
blood from the child and not seeking blood or approvable first from the mother( lf they
would've drawn my blood they would've known that their was no marijuana use And l'm sure
they tested my daughter and didn't have any marijuana use that was a negative statement) if
the intent were to restore the health of the child as a result of a lack of professional behavior
Etheryah now known as Aleshanee sustained many attack which was not bought to my
attention while I was force to comply demand with child protective service... 1"857 dred scott
case clearly states no descendant of African could never be a CITIZEN of UNITED STATES
whether enslaved or those who were free... and as such all documents find instituted black
codes Jim crow laws violation human rights treating mother and child as slave property of the
state This is all crimes against Humanity and as such all claims abuse and neglect are void for
fraud and all should charge with Title 18 USC section 2411091, and brought to justice under

federal rules civil procedure L3 under the United Nations Declarations on the rights of
lndigenous People Article 26 27 28 Father and son was sought 9-2L-16 out and victimize and
kidnap days later to continue in the pot to farther destroy the family tribe unit and were carried

out by Todd H and partner Julie J without a warrant or legal document to validate their force
removing members from the group propaganda was use to carried out their mission and the

father Michael Fullilove known now known as Marshawn shal ul me el has been slender against
and force from any participation in seeking to reunite the family making me face the violent
intrusion along and to defend the right of to stand as a family under the most stressful
condition
This court does not have Jurisdictiorl..... No Jurisdiction over me and my children I have already

stated...we are white and Native American You do not jurisdiction over the free native people
on the Land. This court is Lacking jurisdiction l'm NOT a CITIZEN of UNITED STATES The 1857

the Dred Scott Decision which has


never been overturned that took place here on this Land... no descendant of African could
never be a CITIZEN of UNITED STATES whether enslaved or those who were free... l'm here free
on the Land United Nations second decade of the world lndigenous people I have the right to
U.S. Supreme Court Decision Sanford vs Scott known as

self-identify ...article 33 UNDRIP


The lndigenous Autochthonous children Michael Fullilove and Etheryah Haley is a product
marshawn and Priya Sha ul me el of a union between consenting spouses Any and all claims of

our lndigenous Ani-yun-Wiya Cherokee tribal members as being a citizen subject resident Client
slave minor of the City of ST.LOUIS State of MISSOURI UNITED STATES UNITED OF STATES OF
AMERICAN are propaganda violations of force assimilation and are VOIDED for Fraud
through 5 of the petition are violations of Human rights inciting propaganda slender and force
assimilation as the city of ST.LOUIS and STATE of MISSOURI are corporations Listed on DUNN
and BradStreet which we are not CTTZENS of client or resident of
1

ln response to 5 of the petition NON of our Ani-yun-Wiya Cherokee tribe members come within
the provision of the section 211.031.1(1) RSMO and violating l through 8 of The United Nations
declaration of the right of lndigenous people article 13 and article 33
Etheryah now known as Aleshanee Kerensa Sha el me el was born on lndigenous Land Cahokia
missouria Turtle lsland natural birth without corporate city or state interference or chemical
substance of any kind and has been breastfeed since birth

All allegation By Linda Shaw M.D were not made available to Etheryah parents known as
Aleshanee and can only be construed as propaganda slender and intrude on the rights of tribe
members to KIPNAP our children
Priya not ask to donate blood on our daughter regards PIC line which was force

to have Painful

lnjected into Etheryah known as Aleshanee which cause her to have further health complication
and the modern foreign substance chemicals they was using which her body is NOT use to
would cause her to go into cardiac arrest

Several doctors keep assisting on experimental drugs claiming it

to bEone years old wanted to


experiment with the dosage without give full disclosure of method of treatment or side effect
in respecting of the ancient sacred method of our traditional medical practice Article 24

now known as Priya sha ul me'el was racially profiled and discriminated against
despite lawfully documents which was fax in to the Office management and Budget identifying
I sionya Haley

ourselves as White and Native American I have the right to self lndentify Article 33 UNDRIP
which was their agenda all along to steal our children as they did with no lawfully authority
Juvenile Office Terry Carter admit it that the State of MISSOURI has NO jurisdiction over the
free Native people
Etheryah known as Aleshanee has been breast feed since birth they force me out the hospital
while I was breast feeding my child and til this day I haven't been able to nourish her ever since
9-19-201,6 they knew that I was breast feeding my child they didn't care (staff at cardinal

glennon) all of my rights as a lndigenous woman were violated Article 7


Etheryah known as Aleshanee has been breast since birth and is in harmony with tradition of
our ancestors way of nurturing the body sea moss has 102 minerals that the body is made of
and their many other natural remedies another is called cannabis oil will reverse ALL diseases
known to man including hypothyroidism article 12 article 24 of UNDRIP and UNITED STATES
holds the patent (6630507) which has no side effect lt's ALL natural cannabis oil is use for
natural remedies and not doesn't get you high

Article 10 lndigenous peoples shall not be forcibly removed from their lands or territories. No
relocation shall take place without free prior and informed consent meaning that they have the
right to make decisions on relocation freely without pressure having all the information and
before anything happens. They also have the right to compensation for their relocation
Article 7 lndigenous peoples have the collective right to live in freedom peace and security as
distinct peoples and shall not be subjected to any act of GENOCIDE or any other act of violence
including forcibly removing children of the group to another group

Article 8 lndigenous people and individuals have the right not to be subject to force assimilation
or destruction of their culture 2. STATES shall provide effective mechanisms for prevention of
and redress for Any action which has the aim or effect of depriving them of their integrity as
distinct peoples or of their cultural values or ethnic identities Any form of propaganda designed

to promote or incite racial or ethnic discrimination directed against them Any form of forced
assimilation Any form of forced population transfer which has the aim or effect of violating
undermining any of their rights

My son Michael Fullilove known know as Samon Wijaya Sha ul me el His health is fine just like
any other child out there, their maybe something that may be wrong with them and lf there's
something wrong with him His mother can and will fix the problem the same applies for my
daughter Etheryah Haley now known as Aleshanee Kerensa sha ul me el
The police knock on the door hard and Loudly at my home without a search Warrant 9-21,-16

kipnap Michael Fullilove now known as Marshawn Sha ul me el violation of right article 10 He
presented his SF181 to Todd Todd H Stated You don't want to do this in front of your son do
you? same thing They said to me when they force me out the Hospital They Force me to go to

the Hospital I told them my son has a doctor's appointment They still force me go to the
Hospital...when we got there my son health was okay by RN Tina at Cardinal Hospital...Todd and
Julie J force me out of the Hospital (Cardinal Glennon)Todd H police and Julie J of ST.LOUIS City
Police they didn't show me any paper work they are fraudulent police that is how I know that
my son health was okay because how Todd H and Julie J force me out of the Hospital just to
kidnap my child Michael Fullilove now known as Samon Wijaya Sh ul me el.. A Violation of my
rights Article 7 Article

UNDRIP

My child Etheryah now known as Aleshanee is anemia I Sionya Haley now known as Priya is
anemia too it's heredity and common. The weak bones low platelets low hemoglobin low red
cell blood celland red blood cell enlargement allof that has everything to do with being
anemia... All of that plays apart in being anenmia their trying to make it seem like she had

million things wrong with her she was not severe malnutrition because her weight and height
was normal for her age
The petitioner KATHRYN S HERMANN says the mother appears to be African American...That is
racial profiling and racial discrimination... I sionya Haley now known as Priya sha ul'me el have
Presented My SF181 into the court from the being letting the court know that I am White and
Native American

Me and My family were attack They broke up my family Michael Fullilove now known as
Marshawn Sha ul me el he never had meeting with (Being family together) about our children
Danille Junger the case worker agent that works for the state of Missouri I was force to
cooperation with them to see my children Danille junger Any contract as far as so called frost
parents I signed paper all paper work under threat duress and coercion means all those
contracts are void Danille said she called him for the meeting no one answer or she cannot get

through Michael Fullilove now known as marshawn Sha ul el el said she never called He has the
right to be a part of this as well... UCC1-308 All Rights Reserved wlthmut Frejudice

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Domestic Return Recdipt

l1ltL/2016
Name Michael Fullilove Jr
clo 3916 n Florissant st.louis [63 107]

Name of
Governor: Jeremiah Wilson Jay Nixon
Address P.O. Box 720 Jefferson City
State Missolur, 65102

Dear Govemor : Jay Nixon

Re. Statutory Declaration in accord s,ith U.N. Declaration on the rights of Indigenous
peoples.

Thank,vou for your time.

Cc: Jesuit General Adolpho Nicholas


Cc: Pope Francis I
Cc: VATICAN/HOLY SEE.
Cc: Elizabeth

II

Cc: IINITED STATES PRESIDENT/C.E.O. - Barack Obama

STATUTORY DECLARATION
In the matter of Amendment to Vital Statistics Registration # 124-09-317541 I, Priya Siran Sha 'ul me 'el,
(formerly known as: Sionya Michelle Haley) on Behalf of my son, Michael Anthony Fullilove Jr Now Known
as: Samson Wijaya Sha'ul me'el clo 3916 N. Florissant Apt 205.[63107] do solemnly declare in accord rvith: the
of Elizabeth II, who has no sovereignty and no authority due to violating her oath on June 2,1953);1778 Articles
of Confederation and PerpetualUnion -Art. XI, l8l2 Treaty of Ghent; 1836 Treaty of Marrakesh (Morocco) all
recognized and valid treaties, constitution for the united states of America, the 1948 Charter of the United Nations the
1975 lnter-American Declaration on the right of Indigenous peoples and the United Nations 2"d Decade of the World's
Indigenous People, that upon discovering that the registration of live birth on October 20 ,2009.( in the STATE OF
MISSOURI / Missouri REPUBLIC, was a contract between Mother and STAIE OF MISSOLJRI Corporation)/Missouri
Republic who did not tell her that she was selling my sol1, a flesh and blood child, to STATE OF MISSOURI
(Corporation) as their Chattel Property/Slave/Issue, which is a violation of Human Rights. I as the Father of: Marshawn
Samson Wiaya Sha 'ul me 'el, hereby void the contract ab initio for fraud. My Son is a Flesh And Blood Indigenous /
Autochthonous / Male, a living soul, of Aniyvwiya/Apalachees/Cherokee Descent. in accord with the United Nations
Declaration on the Rights of Indigenous Peoples,
Slavery S.Con.Res26-https://www.govtrack.us/congress/bills/1

1/sconres26/text

US Senate apology to African

Americans for Slavery, u.s. Apology to Native Americans (See 8l l3 H.R.3326 Deparlment of Defense Appropriations
Number:T201077461). On May 14,20ll at SouthWark Crown Court (1 English Ground in SouthWark, London, England)
Defendant: John Anthony Hill in the United Kingdom proved before an English jury that Elizabeth Alexandra Mary
Windsor-Mount Batten Battenburg was not the rightful monarch and never was: The point of argument was that Elizabeth
knew both then and now that she was crowned on a fake coronation stone instead of the real Stone of Destiny /
Coronation Stone, which meant not only was she never properly crowned, but she was also knowingly and fraudulently
conning the pubiic as this is why she did not want her coronation televised. I declared as of : October 20,2409 MICHAEL
ANTHONY FULLILOVE JR on the registration of live Birth ts a corporation and Micheal Anthony Fullilove Jr now
know as Samson Wijaya Sha' ul me'el is an Indigenous Flesh and Blood Male. My Son is not a corporation, artificial
person, natural person or fictitious entity or vessel of the United States defined under Title l8 USC $ 9 and I give notice
Internationally, Domestically, Universally and otherwise via this Declaration that I deny corporate existence. [Jnder
reservation of All My rights Unalienable, Inalienable and otherwise, I declare that He Is: Indigenous I Autochthon of this
Planet and I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force
and effect as if rnade under oath.

Jurat
UnitedNations Declaration on the Rights of Indigenous Peoples
h]tp:1r'rn,

uT,..tur.ordesa"socdevlunpfiildoeur nentslDRiPS:en,pdf

{fN Convention on Economic, Social & Cultural Rights, United Nations Charter
Articles 55 & 56, Presidential Proclamation 7500, HJR 194, S. Con Res 26, HJR-3.
to and subscribed before me this

-fJ-Oay
For

By:

Affiant- UCC '-308 ALL

RESERVE,D

of Octob er 2016.

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UCC I -308 ALL zuGHTS RESERVED


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L0lt4/20t6
Name Etheryah Haley
Address: clo 3916 N Florissant St. Louis [63107]

Name of
Govemor: Jeremiah Wilson Jay Nixon
Address PO. Box 720 Jefferson City
State Missouri 65102

Dear Governor : Jay Nixon


Re. Statutory Declaration in accord with U.N. Declaration on the rights of Indigenous
peoples.

Thank you for your time.

Cc: Jesuit General Adolpho Nicholas


Cc: Pope Francis I
Cc: VATICANIHOLY SEE.
Cc: Elizabeth

II

Cc: UNITED STATES PRESIDENT/C.E.O. - Barack Obama

STATUTORY DECLARATION
In the matter of Amendment to Vital Statistics Registration # 124-13-2A3189 I, Priya Siran Sha 'ul me 'el,
(formerly known as: Sionya Michelle Haley) on Behalf of my daughter, Etheryah Michelle Haley, Now Knowr
as: AleShanee Kerensa Sha ul me el clo 3916 N. Florissant Apt 2A5,{63107] do solemnly declare in accord with:
Coronation of Elizabeth II, who has no sovereignty and no authority due to violating her oath on June 2,1953);
1778 Articles of Confederation and Perpetual Union - Art. XI, I 812 Treaty of Ghent; 1836 Treaty of Marrakesh
(Morocco) all recognized and valid treaties, constitution for the united states of America, the I948 Charter of the United
Nations the l9?5 Inter-American Declaration on the right of Indigenous peoples and the United Nations 2nd Decade of the
World's Indigenous People, that upon discovering that the registration of live birth on November 16,2013,( in the STATE
OF MISSOURI / MissouriREPUBLIC, was a contract between Mother and STATE OF MISSOURI
Corporation/lvlissouri Republic who did not tell her that she was selling my daughter, a flesh and blood child, to STATE
OF MISSOURI (Corporation) as their Chattel PropertylSlave/lssue, which is a violation of Human Rights. I as the Mother
of: Aleshanee Kerensa Sha'ul me 'el, hereby void the contract ab initio for fraud. My Daughter is a Flesh And Blood
Indigenous / Autochthonous / Female, a living soul, of Aniyvwiya/Apalachees/Cherokee Descent, in accord with the
United Nations Declaration on the Rights of Indigenous Peoples,
Slavery S.Con.Res26-https://www.gortrack.us/congress/bills/111/sconres26/text
- US Senate apology to African
Americans for Stavery u.s. Apology to Native Americans (See 8113 H.R.3326 Department of Defense Appropriations
Number:T2UA1746). On May 14,2011at SouthWark Crown Court (i English Ground in SouthWark, London, England)
Defendant: John Anthony Hill in the United Kingdom proved before an English jury that Elizabeth Alexandra Mary
Windsor-Mount Batten Battenburg was not the rightful monarch and never was: The point of argument was that Elizabeth
knew both then and now that she was crowned on a fake coronation stone instead of the real Stone of Destiny /
Coronation Stone, which meant not only was she never properly crowned, but she was also knowingly and fraudulently
conning the public as this is why she did not want her coronation televised. I declared as of : November 16,2013
ETHERYAH SELENA HALEY on the registration of live Birth Is a corporation and Etheryah Selena Haley now known
as Aleshanee Kerensa Sha'ul me'el is an Indigenous Flesh and Blood Female. My Daughter is not a corporation, artificial
person, natural person or fictitious entity or vessel of the United States defined under Title l8 USC $ 9 and I give notice
Internationally, Domestically, Universally and otherwise via this Declaration that I deny corporate existence. Under
reservation of All My rights Unalienalrle, lnalienable and otherwise, I declare that She IS: Indigenous / Autochthon of this
Planet and I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force
and effect as if made under oath.

Jurat
United Nations Declaration on the Rights of Indigenous Peoples

h$e/,

".\nry.un, orgi esa/

UN Convention on Economic, Social & Cultural Rights, UnitedNations Charter


Articles 55 &.56, PresidentialProclamation 7500, HJR 194, S. Con Res 26, HJR-3.
', l

to and subscribed before me

Affiant UCC

this J
1

day of October 2016.

RESERVED

UCC I-308 ALL RIGHTS RESERVED


oduced Identification

_Personally Known
Type and ID#:

fr

SIT
tlota'y cu-friil
STATE

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Name Sionya Haley


Address cla 3916 N Florissant St. Louis [63107]

10/1112016

Name of
Governor: Jeremiah Wilson Jay Nixon
Address P.O. Box 720 Jetlerson Ciry
State Missouri 65102

Dear Governor: Jay Nixon


Re. Statutory Declaration in accord with U.N. Declaration on the rights of Indigenous
peoples.

Thank you for your time.

Cc: Jesuit General Adolpho Nicholas


Cc: Pope Francis I
Cc: VATICAN/T{OLY SEE.
Cc: Elizabeth

II

Cc: UNITED STAIES PRESIDENT/C.E.O. - Barack Obama

Statutory Declaration
In the matterAmendment cf Missouri Heath Division of vital records Registration # 124-89-20A088
I, Sionya Michelle Haley now knorvn as: Priya Siran Sha'ul me'el clo 3916 N Florissant St.Louis Missouri
do solemnly declare in accord rvith: the 1931 Statue of Westminister (
), 1778 Articles
of Confederation and Perpetual Union-Art Xl, 1812 Treaty of Ghent, 1794 tay Treaty; 1836 Treaty of
Marrakesh fir4orocco) all recognized and valid treaties, constitution for the united states ofAmerica, the
1948 Charter of the United Nations" the 1975 inter-American Declaration on the rights of lndigenous
Peoples,Pope'sApologytoIndigenousPeoples(
:
), United Nations
Declaration on the Rights of Indigenous Peoples(tll'{DRiP
,(
) and the United Nations Intemational
D_ecade for People ofAfrican Descent, that upon discovering that the registration of a Live Birth of January
6"' 1989, in the STATE OF MISSOURIifuIISSOURI REPUBLIC called Missouri Republic was a contract
betrveen my mother and the U.S. Government Corporation who did not tell her she was selling me, a flesh
and blood child, to the STAIE OF MISSOURI CORPORATION as the Chattel Property/Slave which is a
violation of Human Rights, I hereby void the contract, ab initio for fraud. I am a Flesh And Blood
Melaninite Cherokee Native American of Turtle Island and of this Planet in accord rvith the United Nations
Declaration on the Rights of Indigenous Peoples, HJR 194- U.S Congress Apologl,to African Americans for
Slavery S. Con, Res. 26 United States Senate
Apology to African Americans for Slavery; u.s. apology To Native Americans (Sec 8113 of H.R.3326
Department of Defense Appropriations Act)
.. Upon
discovering that Elizabeth Alexandra Mary Windsor Mountbatten Battenberg [MISNOMER: Queen
Elizabeth III violated her coronation oath { a legatly binding contract) of June 2d t953. On May 14,7All at
Southward Crown Court (l English Grounds in Southward, London, England) Defendant:John Anthony Hill
in the United Kingdom proved before an English jury that Elizabeth Alexandra Mary Windsor-Mountbatten,
was not the rightful monarch and never was: queen! Elizabeth is not the rightful monarch and never was.
This was a two point argument. Firstly, Elizabeth knew- then and norv- that she was crowned on a fake
coronation stone instead of the real Stone of DestinylCoronation Stone, which meant not only was she
never proprly crowned, but she knolvingly and fraudulently was conning the Public and that is lvhy she did
not rvant her coronation televised. REGINAv.JAIf (case Ref. Number:T20107745) ( See
). I declare that the name SIONYA MICHELLE HALEY on the
registration of the Live birth is a corporation and Sionya Michelte Haley is an lndigenous, Flesh & Blood
Woman. I am Not a corporation, artificial person, natural person, fictitious entity or vessel of the United
States as defined under Title l8 U.S.C. $ 9 and I give notice Internationally Domesically and Universally
via this Declaration that I deny corporate existence. Under reservation of All My Rights Unalienable and
otherwise, I am: Indigenous/Autochthon ofthis planet. And I make this solernn declaration conscientiously
believing it to be true, and knowing that this is the same force and effect as made under oath.

Jurat
United Nations Declaration on the right of Indigenous Peoples(
r,
) 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
Affrrmed to and subscribed before me this

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Guide to Personnel Data Standards

ETHNICITY AND RACE IDENTBFIEATION

(Please read the Privacy Act statement and instructions before completing
iorm.)

Name (Last, First, Middte lnitiat)

\WtEr

E-r

Agency Use dnly

Soclal Security Number

ffi

v\rqlAu S

Birthdate (Month and year)

rl

[.U]iit nr,htr .:i,,li

Prlvacy Aet Statement


Ethn.lgity and race information is requested under the authority of 42 U.S.C. Section 2000e-16 and in ccmptiance with
the Office of Management and Budget's 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 emptoyment status, but in the instance

of missing information, your employing agency will attempt to identify your race and eihnicity by visual observation.

This information is used as necessary to plan for equal employment opportunity throughout the Federal govemment. lt
!s 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 collecled and maintained, or for related urorkforce
studies.

Social Security Number (SSN) is requested under the authority of Executive Order g397, 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 effec{ on your employment status. lf SSN is not provided, however, other agency souices may be
used to obtain it.
Specific lnstructions: The two questions below are designed to identify your ethnicity and race. Regardless of your
guestion 1, go to question 2.
Question

1-

rr"*oJl"-

Are You Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, Soutn or Central American, oiotfrd

Spanish culture or origig, regardless of race.)

Question

2.

EYes R

tto

Please selest the racial category or categories with which you most closely identify by ptacing an .X,,
in ti,"

box. Check as many as apply.

RACIAL CATEGORY
(Check as many as apply)

ft$merican

lndian orAlaska Native

"ppr[?f,;

DEFINITION OF CATEGORY

A person having origins in any of the original peoples of Ertorth and south America
(including central America), and who maintains tribal affiliation or community
attachment.

f!

Asian

A person having origins in any of the original peoples of lhe Far East, Southeast
Asia, or the lndian subcontinent including, for example, Cambodia, China, lndia,
Japan, Korea, Malaysia, Pakistan, the Philippine lslands, Thailand, and Vietnam.

Alacf orAfrican American

A person having origins in any of the black racial groups of Africa.

Native Hawaiian or Other Pacific lstander

A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or
other Pacific lslands.

(Or,wnite

A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa.
Standard Form 181
Revised Augusi 20Os
Previous editions not usable
42 U.S.C. Seciion 2000e-16
NSN 7540-01-09S-3448

TRAt'{tl''1I5FrItit

VEEIFICATIDI'J REPIET
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ETHNlclw AND nacE IDENTIFIGATIoN

U.S. Office of Personnel Management


Guide to Personnel Data Standards

(PleasereadthePrivacyActStatementandinstructionsbeforecompletingform.)
Social SecuritY Number

lnitial

Birthdate (Month and Year)

) tr(

Privacy Act Statement


with
of 42 U.S.C. Section 2000e-16 and in compliance
Ethnicity and race information is requested-under the authority
Race
on
Data
Federal
of
to the standirds for the classification
the office of Management and Budget,s 1gg7 ievisions
on your emp.royment status, but in the instance
has.
ano
voruntarv
is
providing
this information
1o impact
and Ethnicity.
your race and etnnicity by visual observation'
of missing information, your emproying

agency;;iii"lt"rpt

to identity

government' It

Federal
to plan for equal employment opngrtunlty-t]1:'91?lt the
This information is used as necessary-personnel
the records to locate
maintaining
agency
-summary
Management-or employing
is also used by the U. S. otri"" of
descriptive statistics and
and in tn" ii"iouitioi of
individuars for personnel research or.ur"y-i"ip""*
workforce
records are'tottecteo and maintained, orfor related
analytical studies in support of the function forwnicn the
studies.

of Executive order 9397, which requires ssN be used


sociat security Number (ssN) is requested under the authority
Fioviding this information is voluntary and failure

personn"r i""oroi.
for the purpose of uniform, orderly administraiion of
may be
lf ssN is noiprovided,-however, other agency sources
staius.
your
employmlnt
on
to do so wiil have no effect
toidentifyyourethnicityandrace.RegardlessofyouranSwerto
question 1, go to queltion 2'
Question 1. Are You Hispanic or Latino?

Spanish culture or origin, regardless of race')

;::;;::: :;;;;^;

--;--; American, orother


Rican, south orceniral

@rto

ategorieswithwhichyoumostcloselyidentifybyplacingan..X,,intheappropriate

box. Check as many as aPPlY.


DEFINITION OF CATEGORY

RACIAL CATEGORY
(Check as many as aqPlY)

@the

(including

'"no
central nn,,,"*";,

original peoples ot lto.fJl 3nd soutft America


wrro hainiains tribal affiliation or community

attachment.

Southeast

the Far East',


A person having origins in any of the original peoples of Cambodia..China
lndia'
example'
for
includin!,
Asia, or the lndian suncontinent
Thailand' and Vietnam
lslands'
Phili[pine
the
irXi.tun'
Malaysia,
Xor"",
Lupln,

fl

Rsian

f,

atack or African American

groups of Africa
A person having origins in any of the black racial

Native Hawaiian or Other Pacific lslander

ApersonhavingoriginsinanyoftheoriginalpeoplesofHawaii'Guam'Samoa'or
other Pacific lslands.
of Europe' the Middle East' or
A person having origins in any of the original peoples
North Africa.
Standard Form 181
Revised August 2005
Previous editions not usable
42 U.S.C. Section 2000e-16
NSN 7540-01-099-3446

TRA|.J=|4ISSIEr.{ UEFjIFICATITII'I EEFfrET


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sectionr 7 tc),7 {e},9, 12

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45 stat. 401; 54 siat

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and Budget

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ETHNICITY AND RACE IDENTIFICATION

U.S. Office of Personnel Management


Guide to Personnel Data Standards

(Please read the Prrvacy Act statement and instructions before completing form,)

Name {Last, First, Middle lnitial)

Social Security Number

Privacy Act Statement


Ethnlqity and race information is requested under the authority of 42 U.S.C. Section 2000*16 and in
compliance with
Revisions to the Standards for the Classification of Federat 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 aftempt to identify your raie and eihn'icity by visuai observation.

the.ffice of Management and Budgets 1997

This information is used as necessary to plan for equal employment opportunity throughout the Federal government.
lt
i.
.?F9 use! by the U. S. office of Personnel Management'or empioying agency riaintaining the redords to ;ocate
individuals for personnel research or survey responsi and in tne proOuitioi of sumrnary descriptive statistics
and
analyticat studies in support of the function for which the records are collected and maintained, or for relaied
workforce
studies.

Social Security Number (SSN) is requested under the authority of Executive Order g3g7, which requires
SSN be used
fsr the purpose of unifo,rm, orderty administration of personnel iecords. Providing this infoimation 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.

Specificlnstructions:Thetwoquestionsbelovtarea*sign
question 1, go to question 2.

Question1.AreYouHispanicorLatino?(ApersonofCuban,n,r",i"un.
Spanish cuiture or origiL,-regardtess of race.)

Question2,Pleaseselecttheracialcategaryorcategorieswithwhichyournostclose}yidentifyuypffi
box. Check as many as apply.
RACIAL CATEGORY

DEFINiTION OF CATEGORY

(Check as many as apply)

lndian or Alaska Native

q"t:gn having origins in any of the originar peoples of North and south America
{including central America), and who maintains tribai affiliation or community

attachmeni.

fl

Rsian

A person having origins in any of the original peoples of the Far- East, southeast
Asia, oi- the lndian subcontinent including, for'example, cambodia, China, India,
Japan, Korea, Malaysia, pakistan the phiiippine lslands, Thaiiand, ,ni Vi"tnur.

ff

atact or African American

A person having origins in any of the black raclal groups of Africa,

f,

Native Hawaiian or Other pacific Islander

A.person having origins in any of the origlnal peoples of Hauraii, Guam. samoa,
or
other Pacific lslands,

Apersonhavingoriginsinanyoftheoriginal peoplesof Eurooe.theMiddleEast


North Africa.

or

Standard Form 181


Revised August 2005
Previous editions not usable
42 U.S.C. Section 2000e-i6

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United Nations

General Assembly

Distr.: General
December 2014

Sixty-ninth session
Agenda item66 (b)

Resolution adopted by the General Assembly on 18 November 2014


lwithout reference to

Main Committee (A/6g/L 3)l

69116. Programme of activities for the implementation of the


International Decade for People of African Descent
The General Assembly,

Recalling its resolution 681737 of 23 December 2013, by which it proclaimed


the International Decade for People of African Descent, commencing on 1 January
2015 arrd ending on 31 December 2024, with the theme "People of African descent:
recognition, justice and development", to be officially launched immediately
following the general debate of the sixty-ninth session of the General Assembly, and
to this end emphasizing the opportunity for achieving important synergy in the
combating of all the scourges of racism through the effective observance of the
Decade, and. in this regard contributing to the implementation of the Durban
Declaration and Programme of Action,l

Recalling also its resolution 64/169 of 18 December 2009, by which it


proclaimed 2011 as the International Year for People of African Descent, bearing in
mind the primacy of buitding on the gains achieved during the implementation of
the programme of activities for the Year, and to this end recalling paragraph 61 of its
resolution 661144 of 19 December 2011, by which it encouraged the Working Group
of Experls on People of African Descent to develop a programme of action,
including a theme, for adoption by the Human Rights Council, with a view to
proclaiming the International Decade for People of African Descent before the end
of 2073,
Recalling further

its resolution

521111

of

lZDecember 1997, by which it

decided to convene the World Conference against Racism, Racial Discrimination,


Xenophobia and Related Intolerance, and its resolutions 561266 of 27 March 2002,
57/195 of 18 December 2002,58i 160 of 22December 2003,591177 of 20 December
2004 and 601144 of 16 December 2005, which guided the comprehensive follow-up
to the World Conference and the effective implementation of the Durban
Declaration and Programme of Action,

Cognizant

of its resolution 621122 of

designated 25 Marcln as the International Day


Slavery and the Transatlantic Slave Trade,

See A/CONF. 189112

17 December 2007, by which it


of Remembrance of the Victims of

md Corr.l , chap. I

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