The World Government House
South Burlington, VT 05407
"The will of the people shall be the basis of the authority of
government; this will shall be expressed in periodic and genuine elections which shall be
by universal and equal suffrage and shall be held by secret vote or by equivalent free
As a registered Citizen of the World, I hereby fulfill my fundamental world civic right and duty outlined above by voting for a World President to represent me in all matters of common concern for the General Good and the Good of All as defined by the Universal Declaration of Human Rights.
I hereby vote for ________________________________ as World President to represent me as a Citizen of the World. This vote is without prejudice to and in no way affects my status, national or otherwise.
Name _______________________________________________________________ Address ____________________________________________________________ City __________________________________________________ State __________________________ Postal Code _____________ Country ____________________________________________________ World Citizen Registration Number _________________________________ AFFIDAVIT NATION __________________________ STATE _________________________ CITY _________________ On this __________ day of ______________ , ______ , before me personally came _________ __________________________________________________ to me known and known by me to be the person who executed the foregoing form and he/she thereupon duly acknowledged to me that he/she executed the same. Notary ______________________________________________________________________________
World Government House
Merchant Bank, South Burlington, VT 05403
Account Number #3383510