Citizen's Self-Arrest Form
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The government has announced today its proposition to help reduce the deficit and fight the national crime problem as well. They're proposing with the latest tax returns we mail each household in America a Citizen's Self-Arrest Form such as indicated below. This will allow more money to the programs such as weight training for strong arm robbers, Playboy Channel for sex crime inmates, etc.

Fill in this form, answering all questions completely. If you need additional space for a full confession, use a separate blank sheet of paper.

Name _______________________

Address ______________________________

Phone Number (___)_________

Nickname, Alias, AKA _________________

Height ________ Weight _______ Eye Color ______ Hair Color_________

Scars/Marks/Tatoos

___________________________________________________

Crime for which you are arresting yourself

___________________________

Plea: (check one only) [ ] Guilty [ ] Not Guilty [ ] No Contest

Motive: (check one) [ ] Money [ ] Blackmail [ ] Emotional [ ] Ideology [ ] Revenge

[ ] Mental Ill [ ] Romantic Entanglement [ ] Other ______________________

Please follow the rules listed below until your trial date:

  1. Do not leave your domicile
  2. Put any firearms, knives or other potential weapons out of reach
  3. Remove your belt and shoelaces
  4. Read the following statement aloud:

"I am under arrest. I have the right to remain silent. Anything I say may be used against me in a court of law. I have the right to an attorney and to have the attorney present during any questioning and the making of any statements. If I cannot afford an attorney, one will be appointed for me by the court at no cost to me."

5. The small patch below contains a remarkable offshoot of military technology: An entire miniature Bible, produced by laser microprinting. Place your left hand on the spot and raise your right hand and say "I swear that all of the information I have given on this form is true, so help me, God."

XXXXX
XXXXX <---- (Bible)
XXXXX
XXXXX

6. Using a stamp pad or ink soaked sponge, please provide a preliminary set of fingerprints below:

Left

Thumb

Left

Index

Right

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Right

Index

7. If you have a recent photo enclose it for our records, otherwise, if you have a decent amount of artistic skill, please sketch a reasonable likeness on the back of this form. Please do not included any mustache, beard or eyeglasses, even if you actually wear them.

8. Sign and date the form, enclosing the photo if available and mail to Janet Reno Arrest by Mail Program, Washington DC. You are authorized to make one trip to the mail box for this purpose.

 

___________________________________________________

Signature of Arrestor/Arrestee and Date

 

This page was last updated 07/02/00 01:50 PM