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CHECKLIST FOR CITIZENSHIP (Muscogee)

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The Muscogee (Creek) Nation of Oklahoma
Citizenship Board
CHECKLIST FOR CITIZENSHIP
(If the applicant’s signature is in the box below, the checklist is required with your application)
Must complete application for Citizenship (must list name(s) of ancestry and roll number)
The application of an applicant, eighteen (18) years of age or older, must be signed by the applicant
or by the applicant’s parent/legal guardian. The application of an applicant less than eighteen (18)
years of age shall be submitted only by the applicant’s parent possessing legal custody of the minor
or by his/her legal guardian and must be signed by the person submitting the application. (Legal
Guardian(s) must submit the Certified Court records regarding guardianship)
The applicant, parent or legal guardian who signs the application is required to enclose a color copy
of his/her state ID or state Drivers License. (See True Copy of Original Form of Identification(s)
form)
Submit Original/Certified Copy of applicant’s State Certified Full Image Birth Certificate.
If submitting a Computer-Generated, Delayed, or Amended Birth and/or Death Certificate, the
creek parent must complete the attached affidavit for the applicant; if additional documents are
needed, one of the following documents may be requested: Social Security Numident (not to be
confused with the social security number), School Record, or Probated Will which list the person as
a heir.
Submit the Original/Certified Copy of the State Certified Full Image Birth and/or Death Record(s)
of your Non Enrolled ancestry(s) through whom you are tracing.
When tracing back to the original enrollee you must submit a State Certified Death Certificate,
which must list the creek parent(s) as listed on 1906 Dawes Roll.
Copy of the Applicant’s Social Security Card (Must show birth name or current Married/Legal
Name) (See True Copy of Original Form of Identification(s) form)
VETERANS: Applicants, who are veterans, please submit your DD Form 214. For this document
entitles a veteran a specialized Citizenship Card upon acceptance onto the Muscogee (Creek)
Nation Tribal Roll (See True Copy of Original Form of Identification(s) form)
Name Changes due to Marriage and/or Divorce must be documented with an original/certified
copy of the marriage license and/or divorce decree or possibly three forms of identification.
Contact the Citizenship Office for accepted forms of Identification. (See Back of Instructions for
Legal Name Change)
ADOPTIONS: Must submit certified copy of Petition and Final Decree of Adoption and must
include a State Certified Full Image Birth Certificate (After Adoption).
*For all applicants, please enclose a PASSPORT photo of yourself as well as a legible copy of your
State Drivers License or State ID or (if under 18 years old) the State Drivers License or State ID of
parent/legal guardian. (Photo Criteria: color, 2”x2”, white background) (NO Polaroid or
Professional Photos)
*Applicant’s signature is required in the box if passport photo is submitted. Children that
can sign on their own must do so. Children who can't sign on their own must have parent/
legal guardian sign the parent/ legal guardian's name followed by a hyphen "-" and their
relationship to the child. (THIS SIGNATURE WILL BE PLACED ON THE CITIZENSHIP CARD
WITH PHOTO)
*APPLICANT’S SIGNATURE CANNOT TOUCH THE LINES*
Muscogee (Creek) Nation ~ Citizenship Office ~ P.O. Box 580 ~ Okmulgee, OK 74447
You may contact our office at 1-800-482-1979 or (918) 756-8700, ext. 7940/7941/7942/7943
Revised: 01/31/2020
Director
Nathan Wilson
Managers
Andy Proctor
Allan Colbert Jr.
Board Members
Joan Henson
Elizabeth Yahola
Clarence Johnson
Leonard Gouge
Lea Ann Nix
THIS PAGE
INTENTIONALLY
LEFT BLANK
The Muscogee (Creek) Nation of Oklahoma
Citizenship Board
INSTRUCTIONS
To insure your citizenship application is processed in a timely manner, please follow all instructions carefully. Any
deviation from these instructions will delay your membership.
1) Complete the application for citizenship. List the name(s) of your ancestor(s) & roll number(s) from the Index and
Final Rolls of Citizens of The Five Civilized Tribes.
2) The applicant will need to be prepared to update the last enrolled member(s)’ file(s) from their direct lineage at the
discretion of the Director/Manager or his/her designees.
3) Attach your Original STATE CERTIFIED, FULL IMAGE OF THE ORIGINAL BIRTH RECORD. This
document will be signed by the State Registrar, embossed with the State Seal and must list the state file number. All
originals will be returned after they are reviewed.
3)i. If you are submitting a Computer-Generated, “delayed” or amended birth certificate and/or death certificate,
you must include one supporting document that lists the parents’ names, such as a social security abstract, a
school record, or a probated will which lists the person as a heir.
3)ii. CAUTION: Hospital, city and county birth certificates are NOT acceptable. Computer generated, abstracted
or transcribed birth certificates are NOT acceptable. You will need to order the record directly from the State
Vital Statistics Office and specifically request a STATE CERTIFIED, FULL IMAGE OF THE ORIGINAL
BIRTH RECORD. Photocopies are NOT accepted. All originals will be returned after they are reviewed.
4) Submit State Certified, full image of the original birth and/or death record(s) of your NON-ENROLLED ancestor(s)
through whom you are tracing. Please review the CAUTION section above.
4)i. If you provide a death record, it must list the Creek parent(s) name. You will need to provide a supporting
document for each death record. (See supporting document(s) above) (Ex: If your mother is Creek and is not
enrolled, we need her birth record to connect you to the first enrolled member.)
5) When tracing back to the original enrollee, you must submit a State Certified Full Image of the original Birth and/or
Death Certificate(s), which must list the Creek Parent as listed on the Index and Final Rolls of Citizens of the Five
Civilized Tribes. Again, all originals will be returned after they are reviewed.
6) ADOPTION: Applicant(s) are eligible for Citizenship only through the Biological Creek Parent(s). A certified copy
of the Petition for Adoption and the Final Decree of Adoption must accompany the application for Citizenship, as well
as the STATE CERTIFIED, FULL IMAGE OF THE BIRTH RECORD. All information will remain
CONFIDENTIAL.
7) Please send the completed applications with the required documents to: MUSCOGEE (CREEK) NATION
ATTN: CITIZENSHIP BOARD
PO BOX 580
OKMULGEE, OK 74447
(SEE OTHER SIDE FOR ADDITIONAL INFORMATION)
Muscogee (Creek) Nation ~ Citizenship Office ~ P.O. Box 580 ~ Okmulgee, OK 74447
You may contact our office at 1-800-482-1979 or (918) 756-8700, ext. 7940/7941/7942/7943
Revised: 04/04/2019
Director
Nathan Wilson
Managers
Andy Proctor
Allan Colbert Jr.
Board Members
Joan Henson
Elizabeth Yahola
Clarence Johnson
Leonard Harjo
Lea Ann Nix
ATTENTION
- THE TIMEFRAME FOR THE ENROLLMENT PROCESS OF YOUR CITIZENSHIP
APPLICATION VARIES DUE TO THE APPLICATIONS BEING PROCESSED ON A
CASE BY CASE BASIS.
- IN THE REVIEW PROCESS OF THE APPLICANT’S DOCUMENTATION AND
DIRECT LINEAGE, PLEASE BE AWARE THAT ADDITIONAL
DOCUMENTATION MAY OR MAY NOT BE REQUESTED AFTER THE
INFORMATION IS REVIEWED.
REMEMBER: All incomplete applications will be returned. If other documents are needed
you will be contacted.
Please be sure to fill out blanks to the best of your knowledge, being careful to submit maiden
names and previous names - this will help us research your records much faster.
Do not forget a color copy of your social security card - your application will be incomplete and
returned.
Legal Name Changes must be documented with the original/certified copy of the Order of
Name Change court record. The court record must show that is was filed with a County Court
and is signed by the judge.
If unsure about Passport photos, please review this website: http://travel.state.gov/content/
passports/english/passports/photos/photos.html
PASSPORT PHOTO COMPOSITION
REMEMBER: Photocopies of birth or death certificates will not be accepted.
The application of an applicant eighteen (18) years of age or older must be signed by the
applicant or by the applicant’s legal guardian. The application of an applicant less than eighteen
(18) years of age shall be submitted only by the applicant’s parent possessing legal custody of
the minor or by his legal guardian and must be signed by the person submitting the application.
Please help the Citizenship Office update deceased citizen’s information, if your creek parent(s)
or creek grandparent(s) are deceased please submit the death certificate of the citizen or call the
Citizenship office with this information so a death notice may be completed for the deceased
citizen.
If you move during enrollment process, please notify this office at 1-800-482-1979 or (918)
732-7941. MVTO!
Revised: 04/04/2019
The Citizenship Board office is governed by a Citizenship Board consisting of five members. This office provides services to citizens of the Muscogee (Creek) Nation of Oklahoma
or to potential citizens in giving direction or assisting in the lineage verification process of the Muscogee (Creek) people. The mission of this office is to verify the lineage of
descendants of persons listed on the 1906 Dawes Roll of Creek by Blood. In doing so, research is involved in the whole aspect of attaining citizenship.
The criteria for citizenship
is that you must be Creek by blood and trace back to a direct ancestor listed on the 1906 Dawes Roll by issuance of birth and/or death certificates.
I HEREBY CERTIFY THAT THE STATEMENTS GIVEN FOR THE PURPOSE OF MUSCOGEE (CREEK) NATION ENROLLMENT ARE CORRECT AND TRUE TO THE BEST OF MY KNOWLEDGE. BY SIGNING
THIS APPLICATION FOR CITIZENSHIP, I VERIFY THAT ALL INFORMATION PROVIDED IS TRUE AND CORRECT. UNDER MUSCOGEE (CREEK) NATION CODE ANNOTATED TITLE 14, SEC 2-817, IT IS
UNLAWFUL FOR ANY INDIAN PERSON TO WILLFULLY, INTENTIONALLY, AND KNOWINGLY MAKE OR CAUSE TO BE MADE A FALSE APPLICATION TO THE MUSCOGEE (CREEK) NATION FOR THE
PURPOSE OF OBTAINING TRIBAL MEMBERSHIP. AN INDIAN APPLICANT CONVICTED OF VIOLATING THIS SECTION SHALL BE GUILTY OF A MISDEMEANOR AND SHALL BE PUNISHED IN
ACCORDANCE WITH PARAGRAPH 1 OF SUBSECTION B OF TITLE 14, SEC. 1-601.
________________________________________________________________________________________________
SIGNATURE (Required): (Parents must sign for children under 18). Other persons may sign for a minor or disabled person if legal documentation is submitted.
________________________________________________________________________________________________
PRINT NAME (Required): (Parents must sign for children under 18). Other persons may sign for a minor or disabled person if legal documentation is submitted.
1
Revised: 09/30/2019
The Muscogee (Creek) Nation
Citizenship Application
(Please complete application with a black/blue pen)
(Unless stated otherwise, all blocks must be completed or it’s an incomplete application)
Name (First, Middle, Last, Maiden):
Date of Birth:
S.S. #:
Sex: Male Female
Is Applicant Adopted? Yes No
Marital Status: Single Married Widow Separated
Veteran: Yes - (See Checklist)
Home Phone: ( ) -
(Optional) Cell Phone: ( ) -
(Optional) Email:
Physical Address (NO P.O. BOX)
Address:
City:
State:
Zip Code:
County:
Mailing Address
Same as Physical Address: Yes No
Address:
City:
State:
Zip Code:
County:
Tribal Background
Other Indian Blood: Yes No
If yes, list tribe(s):
If the applicant is 18 years or older, does the applicant want the Social Security Number visible on the Citizenship ID Card: Yes No
FOR ADDITIONAL SPACE, PLEASE USE BACK OF THIS PAGE
2
Revised: 09/30/2019
Parents
Mother:
D.O.B:
Tribe & Roll#:
S.S. #:
D.O.D:
Father:
D.O.B:
Tribe & Roll#:
S.S. #:
D.O.D:
Maternal Grandparents
MGMother:
D.O.B:
Tribe & Roll#:
S.S. #:
D.O.D:
MGFather:
D.O.B:
Tribe & Roll#:
S.S. #:
D.O.D:
RECEIVED STAMP HERE
RECEIVED STAMP HERE
RECEIVED STAMP HERE
OFFICE USE ONLY:
RECEIVED STAMP HERE
RECEIVED STAMP HERE
RECEIVED STAMP HERE
PGMother:
D.O.B:
Tribe & Roll#:
S.S. #:
D.O.D:
PGFather:
D.O.B:
Tribe & Roll#:
S.S. #:
D.O.D:
Paternal Grandparents
LINEAGE CHART
(If one or both biological parent(s) are enrolled, complete the parent(s) information then STOP)
KEY:
Maternal - Mother’s Side of the Family D.O.B.: Date of Birth S.S.#: Social Security Number
Paternal - Father’s Side of the Family D.O.D.: Date of Death
The Muscogee (Creek) Nation of Oklahoma
Citizenship Board
NO DUAL ENROLLMENT
Members of the Muscogee (Creek) Nation who are of another American Indian Tribe
must sign an oath saying they are not enrolled with another tribe.
I, ___________________________________, (print applicant’s first-middle-last name)
as a citizen of the Muscogee (Creek) Nation, hereby swear (or affirm) that,
I am not enrolled and will not enroll as a citizen of any other federally
recognized Indian Tribe, Nation Band Pueblo, Rancheria, or Alaska Native
Village, or any other federally recognized Indian entity (except a tribal
town of the Muscogee Nation), without first resigning my enrollment in
the Muscogee (Creek) Nation, or without giving thirty (30) days written
notice to the Citizenship Board of the Muscogee (Creek) Nation.
I further understand that a violation of this oath is punishable by not receiving tribal
services.
____________________________
Signature of Applicant
(Parent or legal guardian must sign if applicant is under 18 yrs. old)
Date: _______________________
Muscogee (Creek) Nation ~ Citizenship Office ~ P.O. Box 580 ~ Okmulgee, OK 74447
You may contact our office at 1-800-482-1979 or (918) 756-8700, ext. 7940/7941/7942/7943
Revised: 04/04/2019
Director
Nathan Wilson
Managers
Andy Proctor
Allan Colbert Jr.
Board Members
Joan Henson
Elizabeth Yahola
Clarence Johnson
Leonard Gouge
Lea Ann Nix
THIS PAGE
INTENTIONALLY
LEFT BLANK
The Muscogee (Creek) Nation of Oklahoma
Citizenship Board
AUTHORIZATION FOR RELEASE OF INFORMATION
I, ___________________________________, (print applicant’s first-middle-last name)
authorize the release of information requested by or from the Citizenship Board of the
Muscogee (Creek) Nation. The requested information shall be used solely in the
administration of citizenship related programs.
This release includes, but is not limited to, the following agencies:
Programs and Services of the Muscogee (Creek) Nation, Bureau of Indian Affairs,
Indian Health Services, School Authorities, local, state and federal agencies.
____________________________ Date: ______________
Signature of Applicant
(Parent or legal guardian must sign if applicant is under 18 yrs. old)
The above signature is by:
( ) Self
( ) Next-of-Kin
( ) Authorized Representative
Muscogee (Creek) Nation ~ Citizenship Office ~ P.O. Box 580 ~ Okmulgee, OK 74447
You may contact our office at 1-800-482-1979 or (918) 756-8700, ext. 7940/7941/7942/7943
Revised: 04/04/2019
Director
Nathan Wilson
Managers
Andy Proctor
Allan Colbert Jr.
Board Members
Joan Henson
Elizabeth Yahola
Clarence Johnson
Leonard Gouge
Lea Ann Nix
THIS PAGE
INTENTIONALLY
LEFT BLANK
The Muscogee (Creek) Nation of Oklahoma
Citizenship Board
True Copy of Original Form of Identification(s)
I, _____________________________________________, (the adult applicant or parent/legal guardian of the applicant)
(Print First Middle Last Name)
affirm that the identification checked above and attached is/are a true and complete copy of the document which it purports
to represent.
Signature: __________________________________________ Date: __________________
You must sign and date this form in front of a Notary Public.
____________________________________________________________________________________________________________
NOTARY PUBLIC USE ONLY
State of _______________________
County of _____________________
Subscribed and sworn to before me this __________ day of _________________________________, 20_____.
____________________________________________
Notary Public Signature
My Commission Expires:______________________
Muscogee (Creek) Nation ~ Citizenship Office ~ P.O. Box 580 ~ Okmulgee, OK 74447
You may contact our office at 1-800-482-1979 or (918) 756-8700, ext. 7940/7941/7942/7943
Revised: 05/01/2019
Director
Nathan Wilson
Managers
Andy Proctor
Allan Colbert Jr.
Board Members
Joan Henson
Elizabeth Yahola
Clarence Johnson
Leonard Gouge
Lea Ann Nix
Please check the box(es) that apply and attach the designated color-copy ID to this Document
NOTARY STAMP
STAND-ALONE PRIMARY FORM OF
IDENTIFICATION
State ID Card or Driver’s License (No
more than 3 months expired)
Oklahoma Self Defense Act License
(Concealed/Open Carry License) (No More
than 3 months expired)
United States Passport (No more than 3
months expired)
Out-of-State Drivers License
**Current Citizenship ID Card with Photo
(No more than 3 months expired)
An identification document issued by the
United States Armed Services (Issued by
the Department of Defense); one of the
following:
Military identification card
Military dependent identification card
** Identity must have been verified with
acceptable identification and/or documentation
with the MCN Citizenship Office
SECONDARY FORM OF IDENTIFICATION
(Original Birth Certificate Required)
Any primary of identification, which is
not used as the primary ID for a U.S.
Citizen
For any person under the age of 18, an
affidavit signed by the parent or legal
guardian
Identification Document issued by the
one of the following:
Oklahoma public, private, or
parochial secondary school
Oklahoma institution of higher
education
Oklahoma technology center
school
Oklahoma employer
Oklahoma gun permit
Pilot license
Oklahoma lifetime hunting or
fishing license
Oklahoma voter identification card
Social Security card
Health insurance card
Cont…
SECONDARY FORM OF IDENTIFICATION
(Original Birth Certificate Required)
Oklahoma Medical Marijuana Adult/
Minor Patient Card
Motor vehicle registration or title
Marriage Certificate
Separation or divorce judgment
Professional degree, certificate, or
license
Deed or title to property in Oklahoma,
including a burial plot deed
Health, life, or home insurance policy
issued to the applicant
Automobile insurance policy or
security verification form issued to the
applicant
A valid U.S.D.O.T. health card, as
required by 49 C.F.R. Part 391
** Digital photograph comparison, if a
digital photograph is already on file
with the MCN Citizenship Office
Military discharge (DD-214), unless
specified not to be used for
identification
** Identity must have been verified with acceptable
identification and/or documentation with the MCN
Citizenship Office
THIS PAGE
INTENTIONALLY
LEFT BLANK
The Muscogee (Creek) Nation of Oklahoma
Citizenship Board
AFFIDAVIT OF MATERNITY
I, _________________________________, (Born on: __________________ and Place of Birth:
Print MOTHER’S Full Maiden Name MOTHER’S Date of Birth
_______________________________) of lawful age, being first duly sworn, deposes and
MOTHER'S Place of Birth (State Only)
says as follows:
I hereby acknowledge I am the biological mother of ___________________________________,
Print CHILD’S Full Name
born on ____________________. The birth occurred in the State of and
CHILD’S Date of Birth
NO ADOPTION has taken place. I understand if I submit any false information, all rights and
privileges of citizenship in the Muscogee (Creek) Nation will be irrevocably removed.
____________________ __________________________________
Date Biological Mother’s Signature & Roll No.
You must sign and date this form in front of a notary public.
______________________________________________________________________________
NOTARY PUBLIC USE ONLY
State of _____________________
County of _____________________
Subscribed and sworn to before me this _______ day of _____________________, 20 ______.
My commission expires:
___________________ _________________________________
Notary Public
Muscogee (Creek) Nation ~ Citizenship Office ~ P.O. Box 580 ~ Okmulgee, OK 74447
You may contact our office at 1-800-482-1979 or (918) 756-8700, ext. 7940/7941/7942/7943
Revised: 05/13/2019
Director
Nathan Wilson
Managers
Andy Proctor
Allan Colbert Jr.
Board Members
Joan Henson
Elizabeth Yahola
Clarence Johnson
Leonard Gouge
Lea Ann Nix
THIS PAGE
INTENTIONALLY
LEFT BLANK
The Muscogee (Creek) Nation of Oklahoma
Citizenship Board
AFFIDAVIT OF PATERNITY
I, _________________________________, (Born on: __________________ and Place of Birth:
Print FATHER’S Full Name FATHER’S Date of Birth
_______________________________) of lawful age, being first duly sworn, deposes and
FATHER’S Place of Birth (State Only)
says as follows:
I hereby acknowledge I am the biological father of ___________________________________,
Print CHILD’S Full Name
born on ____________________. The birth occurred in the State of and
CHILD’S Date of Birth
NO ADOPTION has taken place. I understand if I submit any false information, all rights and
privileges of citizenship in the Muscogee (Creek) Nation will be irrevocably removed.
____________________ __________________________________
Date Biological Father’s Signature & Roll No.
You must sign and date this form in front of a notary public.
______________________________________________________________________________
NOTARY PUBLIC USE ONLY
State of _____________________
County of _____________________
Subscribed and sworn to before me this _______ day of _____________________, 20 ______.
My commission expires:
___________________ _________________________________
Notary Public
Muscogee (Creek) Nation ~ Citizenship Office ~ P.O. Box 580 ~ Okmulgee, OK 74447
You may contact our office at 1-800-482-1979 or (918) 756-8700, ext. 7940/7941/7942/7943
Revised: 05/13/2019
Director
Nathan Wilson
Managers
Andy Proctor
Allan Colbert Jr.
Board Members
Joan Henson
Elizabeth Yahola
Clarence Johnson
Leonard Gouge
Lea Ann Nix
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CHECKLIST FOR CITIZENSHIP (Muscogee)

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Completed 20 July 2020

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