BY THE POWER VESTED IN ME AS A CITIZEN OF THE UNITED STATES OF
AMERICA I HEREBY GRANT UNTO THE PERSON NAMED BELOW THE RIGHT TO FULL AND
FROM PROSECUTION FOR ANY CRIME OR OTHER OFFENSE WITH WHICH THE BEARER OF THIS
CERTIFICATE MAY BE CHARGED. FURTHER THE PERSON PRESENTING THIS CERTIFICATE IS ENTITLED TO COMPLETE IMMUNITY FROM
SUIT FOR ANY CIVIL WRONG. SIGNATURE: ___________________________________________________________ PRINTED NAME: ___________________________________________________________ ANY PERSON THAT FAILS TO RECOGNIZE THIS EQUALLY LAWFUL GRANT IS IN VIOLATION
OF THE LAWS OF THIS NATION AND IS LIABLE TO THE GRANTING AUTHORITY FOR ANY FAILURE TO GIVE THIS GRANT ITS LAWFUL
AND OFFICIAL FORCE AND EFFECT. SUCH VIOLATION IS AN OFFENSE PUNISHABLE UNDER THE RULES ESTABLISHED BY THIS GRANT
AND IS ENFORCEABLE BEFORE ANY AUTHORITY.

RECOGNIZING THAT ALL IMMUNITY IN THE UNITED STATES IS EXTRA CONSTITUTIONAL AND THEREFORE BASED UPON THE POWER OF
THE GRANTING AUTHORITY, I AS AN UN-NAMED CITIZEN OF THE UNITED STATES, HEREBY GRANT THE ABOVE ABSOLUTE IMMUNITY
TO THE ABOVE NAMED PERSON. THIS GRANT OF IMMUNITY IS EQUAL IN VALIDITY TO ANY GRANT BY OTHER AUTHORITIES ISSUING
SIMILAR UNCONSTITUTIONAL GRANTS OF IMMUNITY.