Form 1026-2001 - United States Citizen Consent Form And Survey


Form 1026-2001
United States Citizen Consent Form and Survey
Must Be Filled Out by All Citizens and Sent to Dept of Homeland Security
1. The United State Government may listen in on all my phone calls, it may
secretly review all my mail and email, and it may seize any other information
about me using any means. Yes ____ No ____
[Note: by failing to check “yes,” you will have given the U.S. Government probable cause to spy on
you, to include all of your phone calls, mail, email and any other information about you.]
2. I relinquish all expectation of participating in the U.S. Government as a
concerned citizen. Henceforth, I ask the U.S. Government to consider the
large corporations who give money to Congressional candidates to be my
Yes ____ No ____
3. My position is that “government is the problem” and that we should
therefore defund all federal programs except for our vast war machine.
Yes ____ No ____
4. I insist that the United States continue to rely heavily on petroleum, coal
and other fossil fuels. I am also in favor of a law prohibiting anyone from
suggesting that our current energy policy is unsustainable or dangerous to
Americans. Yes ____ No ____
5. The “invisible hand” and the “free market” will take care of everything. All
people need to do is live locally and everything will take care of itself.
Yes ____ No ____
6. Terrorists from the Middle East are America's biggest problem, along with
gays who get married and people who don’t go to church. Yes ____ No ____
7. Please describe in detail where you keep all of your important information
(Internet storage cloud, email services, safety deposit boxes, file cabinets,
locations of backup hard drives). Attach separate sheets to provide a highly
detailed answer:
Your Name
Erich Vieth 2011 


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Parent category: Legal