All entities seeking citizenship of Lower Light must submit this form entirely to the best of their abilities. All citizenship forms are CONFIDENTIAL
Registration Form CSLL-446B
1.FULL LEGAL NAME (THE NAME GIVEN TO YOU UPON YOUR [INCLUDING BUT NOT LIMITED TO]: BIRTH, HATCHING, EVOLUTION, CREATION, SPAWNING, ERUPTION, ARRIVAL OR APPEARANCE]: Nathaniel Henderson
2. ALL KNOWN ALIASES (LIST ALL THAT APPLY): N/A
3. BIOLOGICAL AGE: 27
4. BIOLOGICAL SEX: Male
5. LONGEVITY (SELECT ONE):
-ALTERED LIFESPAN (+ OR - 50+ YEAR OF NATURALLY EXPECTED LIFESPAN): [__]
-NATURAL LIFESPAN (EXPECTED LIFESPAN FOR SPECIES, BREED AND SEX): [X]
-ALTERED IMMORTALITY (IMMORTALITY GRANTED VIA MAGICAL CHARM, RUNE, ENCHANTMENT OR BLESSING): [__]
-NATURAL IMMORTALITY (IMMORTALITY GRANTED VIA BIRTH, SPECIES, BREED OR SEX): [__]
6. BIRTH DATE (TO THE CLOSEST APPLICABLE YEAR): 7/20/1992
7. BIRTH LOCATION: Detroit, Michiga
8. APPARENT SPECIES:
Imbued (World of Darkness supernatural hunters
')
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IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
9. BIOLOGICAL SPECIES:
Human
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____________________________
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IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
10. ARE YOU AN ALTERED ENTITY (CHECK ONE): YES [X] NO [__]
IF YES, STATE ANY AND ALL ALTERED ENTITY IDENTIFIERS (INCLUDING BUT NOT LIMITED TO: VAMPIRES, WERE-CREATURES, HALF-BREEDS, SHAPESHIFTERS, LICHES, MUMMIES, DRAUGR, ZOMBIES, UNDEAD) [ooc note: Basically any type of fantasy creature that can be 'created' and not a 'race']: Imbued
10A. SELECT ONE (1) IDENTIFIER:
-CIVILIAN (CIV) [X]
-MILITARY (MIL) [__]
-GOVERNMENTAL SERVICES (GSR) [__]
-REGISTERED CRIMINAL (BAD) [__]
IF REGISTERED, LIST ALL APPLICABLE INCARCERATIONS AND DETAINMENT INCLUDING REASON, YEAR & LOCATION:
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
-VETERAN MILITARY (VET) [__]
-MILITARY RESERVES (MIR) [__]
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF PERSONAL IDENTIFIER CHANGES.
11. ARE YOU A MAGICAL ENTITY (CHECK ONE): YES [X] NO [__]
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF MAGICAL STATUS CHANGES.
11A. LIST MAGICAL ABILITIES AND IDENTIFY EACH AS LETHAL OR NON-LETHAL:
Ink Production/Manipulation - Non-Lethal
Second Sight - Non-Lethal
Accelerated Healing - Non-Lethal
Enhanced Fighting - Non-Lethal
Barrier - Non-Lethal
Buff - Non-Lethal
Winds of Heaven - Lethal
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IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
11B: SELECT ONE (1) IDENTIFIER:
- NON-MAGICAL ENTITY (NME) [__]
--NO MAGICAL ABILITY
- MAGICAL-ENTITY-L (ME1) [__]
-- MINOR MAGICAL ABILITY. NON-LETHAL. UNTRAINED OR LIMITED TRAINING
-MAGICAL-ENTITY-M (ME2) [__]
--MODERATE MAGICAL ABILITY. NON-LETHAL. TRAINED.
-MAGICAL-ENTITY-H (ME5) [X]
--HIGH MAGICAL ABILITY. LETHAL OR NON-LETHAL MAGICS. TRAINED OR HIGHLY TRAINED
-MAGICAL-ENTITY-S (ME7) [__]
--HIGH MAGICAL ABILITY. LETHAL OR NON-LETHAL MAGICS. SPECIALLY TRAINED OR MASTER OF MAGICAL SUBJECT
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF MAGICAL IDENTIFIER CHANGES.
12. LEGAL RESIDENCE: Tu Madre Casa, Lower Light, Eriu
13. REGISTERED PROFESSION: Tattoo Artist
13A. PROFESSIONAL ADDRESS: N/A
14. LEGAL FAMILY MEMBERS (FUNCTIONALLY LIVING MEMBERS ONLY):
Anthony Henderson
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____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF FAMILY DYNAMIC CHANGEs.
15. BLOOD TYPE: B-
16. LEFT THUMB FINGERPRINT: Insert Here
17: IDENTIFYING PHOTOGRAPH: Insert Here
SIGNATURE AND DATE:
Nathaniel Henderson 4/1/2020
BY SIGNING THIS DOCUMENT I (THE APPLICANT OF THIS DOCUMENT AND/OR THEIR GUARDIANS) HEREBY ACKNOWLEDGE THAT ANY AND ALL INFORMATION SUBMITTED ON DOCUMENT CSLL-446B IS COMPLETE AND TRUTHFUL TO THE BEST OF MY ABILITY. ANY FALSIFYING OF INFORMATION OR DOCUMENTS WILL BE PERSECUTED TO THE FULLEST EXTENT OF THE LAW. BY SIGNING THIS DOCUMENT I (THE APPLICANT OF THIS DOCUMENT AND/OR THEIR GUARDIANS) HEREBY AGREE TO BE ADDED TO THE CITY OF LOWER LIGHT'S GOVERNMENTAL CENSUS AND AGREE THAT ANY FALSIFIED INFORMATION OR DOCUMENTS WILL TERMINATE YOUR CITIZENSHIP OR APPLICATION OF CITIZENSHIP OF LOWER LIGHT AND WILL RESULT IN IMMEDIATE DEPORTATION.
Registration Form CSLL-446B
1.FULL LEGAL NAME (THE NAME GIVEN TO YOU UPON YOUR [INCLUDING BUT NOT LIMITED TO]: BIRTH, HATCHING, EVOLUTION, CREATION, SPAWNING, ERUPTION, ARRIVAL OR APPEARANCE]: Nathaniel Henderson
2. ALL KNOWN ALIASES (LIST ALL THAT APPLY): N/A
3. BIOLOGICAL AGE: 27
4. BIOLOGICAL SEX: Male
5. LONGEVITY (SELECT ONE):
-ALTERED LIFESPAN (+ OR - 50+ YEAR OF NATURALLY EXPECTED LIFESPAN): [__]
-NATURAL LIFESPAN (EXPECTED LIFESPAN FOR SPECIES, BREED AND SEX): [X]
-ALTERED IMMORTALITY (IMMORTALITY GRANTED VIA MAGICAL CHARM, RUNE, ENCHANTMENT OR BLESSING): [__]
-NATURAL IMMORTALITY (IMMORTALITY GRANTED VIA BIRTH, SPECIES, BREED OR SEX): [__]
6. BIRTH DATE (TO THE CLOSEST APPLICABLE YEAR): 7/20/1992
7. BIRTH LOCATION: Detroit, Michiga
8. APPARENT SPECIES:
Imbued (World of Darkness supernatural hunters
')____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
9. BIOLOGICAL SPECIES:
Human
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
10. ARE YOU AN ALTERED ENTITY (CHECK ONE): YES [X] NO [__]
IF YES, STATE ANY AND ALL ALTERED ENTITY IDENTIFIERS (INCLUDING BUT NOT LIMITED TO: VAMPIRES, WERE-CREATURES, HALF-BREEDS, SHAPESHIFTERS, LICHES, MUMMIES, DRAUGR, ZOMBIES, UNDEAD) [ooc note: Basically any type of fantasy creature that can be 'created' and not a 'race']: Imbued
10A. SELECT ONE (1) IDENTIFIER:
-CIVILIAN (CIV) [X]
-MILITARY (MIL) [__]
-GOVERNMENTAL SERVICES (GSR) [__]
-REGISTERED CRIMINAL (BAD) [__]
IF REGISTERED, LIST ALL APPLICABLE INCARCERATIONS AND DETAINMENT INCLUDING REASON, YEAR & LOCATION:
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
-VETERAN MILITARY (VET) [__]
-MILITARY RESERVES (MIR) [__]
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF PERSONAL IDENTIFIER CHANGES.
11. ARE YOU A MAGICAL ENTITY (CHECK ONE): YES [X] NO [__]
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF MAGICAL STATUS CHANGES.
11A. LIST MAGICAL ABILITIES AND IDENTIFY EACH AS LETHAL OR NON-LETHAL:
Ink Production/Manipulation - Non-Lethal
Second Sight - Non-Lethal
Accelerated Healing - Non-Lethal
Enhanced Fighting - Non-Lethal
Barrier - Non-Lethal
Buff - Non-Lethal
Winds of Heaven - Lethal
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
11B: SELECT ONE (1) IDENTIFIER:
- NON-MAGICAL ENTITY (NME) [__]
--NO MAGICAL ABILITY
- MAGICAL-ENTITY-L (ME1) [__]
-- MINOR MAGICAL ABILITY. NON-LETHAL. UNTRAINED OR LIMITED TRAINING
-MAGICAL-ENTITY-M (ME2) [__]
--MODERATE MAGICAL ABILITY. NON-LETHAL. TRAINED.
-MAGICAL-ENTITY-H (ME5) [X]
--HIGH MAGICAL ABILITY. LETHAL OR NON-LETHAL MAGICS. TRAINED OR HIGHLY TRAINED
-MAGICAL-ENTITY-S (ME7) [__]
--HIGH MAGICAL ABILITY. LETHAL OR NON-LETHAL MAGICS. SPECIALLY TRAINED OR MASTER OF MAGICAL SUBJECT
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF MAGICAL IDENTIFIER CHANGES.
12. LEGAL RESIDENCE: Tu Madre Casa, Lower Light, Eriu
13. REGISTERED PROFESSION: Tattoo Artist
13A. PROFESSIONAL ADDRESS: N/A
14. LEGAL FAMILY MEMBERS (FUNCTIONALLY LIVING MEMBERS ONLY):
Anthony Henderson
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
IF ADDITIONAL SPACE IS REQUIRED, SEE NEXT PAGE.
NOTE: YOU ARE REQUIRED BY LAW TO SUBMIT A NEW CSLL-446B FORM WITHIN THREE (3) BUSINESS DAYS IF FAMILY DYNAMIC CHANGEs.
15. BLOOD TYPE: B-
16. LEFT THUMB FINGERPRINT: Insert Here
17: IDENTIFYING PHOTOGRAPH: Insert Here
SIGNATURE AND DATE:
Nathaniel Henderson 4/1/2020
BY SIGNING THIS DOCUMENT I (THE APPLICANT OF THIS DOCUMENT AND/OR THEIR GUARDIANS) HEREBY ACKNOWLEDGE THAT ANY AND ALL INFORMATION SUBMITTED ON DOCUMENT CSLL-446B IS COMPLETE AND TRUTHFUL TO THE BEST OF MY ABILITY. ANY FALSIFYING OF INFORMATION OR DOCUMENTS WILL BE PERSECUTED TO THE FULLEST EXTENT OF THE LAW. BY SIGNING THIS DOCUMENT I (THE APPLICANT OF THIS DOCUMENT AND/OR THEIR GUARDIANS) HEREBY AGREE TO BE ADDED TO THE CITY OF LOWER LIGHT'S GOVERNMENTAL CENSUS AND AGREE THAT ANY FALSIFIED INFORMATION OR DOCUMENTS WILL TERMINATE YOUR CITIZENSHIP OR APPLICATION OF CITIZENSHIP OF LOWER LIGHT AND WILL RESULT IN IMMEDIATE DEPORTATION.
Moderators: Postey