First-name Last-nameAddress

City, State (no zip code) Phone #

Email AddressDate of Mailing and Email: _____________

Mailed and Emailed to : 1

U.S. Department of Health and Human Services (HHS) Civil Rights Division – Inquiry Ph (800) 368-1019OCRMail@hhs.gov &U.S. Department of JusticeCivil Rights Division (DOJ) – Inquiry Ph (877) 292-3804education@usdoj.gov&U.S. Department of Education (DOEd)Civil Rights Office – Inquiry Ph (800) 421-3481OCR@ed.gov

ATTN: Roger Severino, HHS Director of Civil Rights Divisionc/o HHS Conscience and Religious Freedom Division

Shaheena Simons, DOJ Chief, Civil Rights Divisionc/o Educational Opportunities Section

Candice Jackson, DOEd Acting Assistant Secretary for Civil Rightsc/o Office of Civil Rights

RE: VACCINE CONSCIENCE & RELIGIOUS FREEDOM CLASS ACTION COMPLAINT-- MY CHILD’S CONSCIENCE AND RELIGIOUS FREEDOM RIGHT TO ATTEND SCHOOL WITHOUT MANDATORY VACCINATIONS

RELIGIOUS DISCRIMINATION AND VIOLATION OF PERSONAL, MEDICAL, CONSCIENCE, MORAL AND RELIGIOUS FREEDOM RIGHTS

VIOLATING AND DISCRIMINATINGPARTIES:

- School Superintendent’s First & Last Name, Title Name of child’s School District Address City Phone number- California Senator Richard Pan (SB 277) State Capitol, Room 5114, Sacramento, CA 95814, (916) 651-4006- California Governor Jerry Brown State Capitol, Suite 1173, Sacramento, CA 95814, (916) 445-2841- Et Al individuals and organizations promoting and enforcing any state law whose actions affect the education of certain children for lack of vaccination

HEREINAFTER “CRIMINAL PARTICIPANTS”

1 Mailing addresses for each department are listed below in Declaration Statement footnote.Page 1 of 22

PRESIDENTIAL DECLARATION AND INSTRUCTIONS TO CABINET SECRETARIES

“PROTECT RELIGIOUS LIBERTIES …FAITH AND FAMILY ARE THE CENTER OF AMERICAN LIFE

THE MOTTO IS ‘IN GOD WE TRUST’ …

REMOVE FEDERAL EMPLOYEES WHO UNDERMINE THE PUBLIC TRUST OR FAIL THE AMERICAN PEOPLE”

President Donald J. TrumpState of the Union Address – January 30, 2018

GENERAL JURISDICTIONAL RESPONSIBILIITY OF INVOLVED AUTHORITIESHHS: HHS enforces federal laws that protects conscience and the free exercise of religion and prohibits coercion and discrimination in health and human services.

DOJ: The DOJ Educational Opportunities Section is responsible for enforcing Title IV of the Civil Rights Act of 1964, which prohibits discrimination on the basis of race, color, national origin, sex, and religion in public schools and institutions of higher learning.

DOEd: The DOEd’s Office of Civil Rights mission is to ensure equal access to education and to promote educational excellence through vigorous enforcement of a person’s constitutionally protected civil rights in our nation’s schools, including the application of a person’s religious rights and freedom regarding a parent’s choice to vaccinate or not to vaccinate their children based on their personal, medical, conscience and religious beliefs as to the potential or actual harm that vaccines may cause on their children.

INTRODUCTION

I, Your Name (Xxxx, leave in bold, underlined and highlighted), a man/woman and Child of God, hereinafter the “Complainant”, submit the following Conscience and Religious Freedom Rights Complaint, hereinafter referred to as my “Vaccine Religious Freedom Class Action Complaint”, to the U.S. Department of Health & Human Services, Civil Rights Division, Conscience and Religious Freedom Division, in association and conjunction with the U.S. Department of Justice, Civil Rights Division, Educational Opportunities Section; and the U.S. Department of Education, Office of Civil Rights, on my behalf, and on behalf of my children and family, as well as on behalf of all parents and their children whose conscience and religious beliefs are being threatened and affected by the Criminal Participants referenced herein, whose actions, individually and together, are resulting in the illegal restriction to education for children that do not comply with state vaccine schedule as noted in Senate Bill SB 277 (SB 277), which actions are in violation of my and such parents and their children’s CONSCIENCE AND RELIGIOUS RIGHTS AND FREEDOM to not vaccinate their children based on such beliefs.

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I believe and allege that I and others in My Class2 referenced herein have been discriminated against on the basis of my and our conscience and religion freedom beliefs, in violation of our Conscience and Religious Rights as reflected in the First Amendment to the U.S. Constitution, included in all applicable versions of the U.S. Constitution since the September 17, 1787 version.

My God-given rights are reflected, confirmed and secured in Natural Law, Common Law, the U.S. Declaration of Independence and International Law, all of which are not dependent on, but are simply restated in the U.S. Constitution in its First Amendment, which reads,

“Congress Shall Make No Law Respecting an Establishment of Religionor Prohibiting the Free Exercise Thereof”

SPECIFIC PERSONS AFFECTED NAMED IN THIS COMPLAINT

Aside from all persons in general noted, reference and or implied herein whose conscience and religious freedom rights are being violated or threatened to be violated by SB 277 and its implementation by the named Criminal Participants and other California authorities, this Vaccine Religious Freedom Class Action Complaint identifies specifically the following persons as being harmed by the Criminal Participants:

(example of how SB 277 or any other law affects you)

(1) SUBMITTED ON MY AND MY CHILDREN’S3 BEHALF. I, Your First and Last Name, have a child4 by the name of Jane Doe, who is not and or will not be allowed to attend public or private school because she is not fully vaccinated as required by SB 277 and the authorities responsible for implementing such bill, such as my daughter’s school district Superintendent Sup First and Last name, Senator Richard Pan and Governor Brown who are violating me and my children’s conscience and religious freedom rights due to their actions.

See Exhibit 1, email correspondence with the involved school district personnel, including Superintendent Sup Last Name, where (a) the Superintended was provided my Personal and Religious Belief Exemption Notification Letter for my child, was told that I believed that my child has the right to attend school even though my child was or is not current on the vaccinations and did not have a vaccine medical exemption, and where (b) the superintendent confirms that my child will not be allowed to attend school simply based on my conscience and religious beliefs not to vaccinate my child.

TIMELINESS OF COMPLAINT: The violation of my conscience and religious freedom beliefs and rights started upon the implementation of SB 277 on January 1, 2016, when no more vaccine personal and supposedly religious (sic) exemptions would be accepted by school personnel, and this continues to this day. Even exemptions filed timely are considered null and void once a child goes to the next grade level, such as 7th grade.

2 As used herein “Class” and “My Class” means me and those men, woman and children that find themselves in the same circumstances as me as regards being denied schooling for their children for lack of being up-to-date as to their children’s mandatory vaccination school requirements. It also includes any person in the medical field, or otherwise, whose rights are being violated for being against some or all vaccination for conscience or religious freedom beliefs.3 As used herein, my “child” and “children” refers to any man, woman and or boy or girl child under my parental or custodial care presently or in the future. All words in this contract are as I understands them. 4 As used herein, “child” and “children” means a man or woman below the age of puberty, a Child of God.

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Further, California authorities are moving to remove the religious exemptions from colleges and universities, which would also ignore any previously submitted exemption letters/affidavits.

PETITION TO EXPEDITE COMPLAINT INVESTIGATION AND ENFORCEMENT

Due to the fact that enrollment for the 2018-2019 school year will begin in March of 2018, I respectfully request that you expedite (1) the review of my complaint, (2) the investigation of my complaint, and (3) the enforcement of my complaint in the form of legal action against Superintendent Last Name and the Name Elementary/High School District.

Failure to do so may and will result in (1) my child missing school, and or worse (2) my child being vaccinated in order to attend school and as a result potentially being physically or mentally harmed by such newly administered vaccine(s) and their toxic ingredients.

CONSCIENCE AND RELIGIOUS FREEDOM RIGHT FOR A PERSON5 TO GET A MEDICAL EXEMPTION FOR HIS/HER CHILD REGARDING MANDATORY VACCINATION

Me, as an Individual

This aforementioned conscience and religious freedom rights and the free exercise thereof includes my right to not vaccinate my children based on the following:

(1) My personal conscience belief that vaccines contain toxic substances that may affect in minor, major and/or fatal ways the health of my child or children if I were to allow them to be injected with the vaccines allegedly mandated by SB 277; and

(2) My religious rights, religious belief and God-ordained obligation to not allow my children, God’s Temple, to be defiled by toxic, dangerous, potentially and actually harmful components found in vaccines, individually or synergistically, in particular in the case of injection of multiple vaccinations at the same time or in close proximity one to the other.

This vaccine harm is especially the case when such antigens are introduced into the body through injection in a syringe containing animal and human DNA and protein, detergents, formaldehyde and neurotoxins including mercury and aluminum. Multiple antigens combined with toxic/carcinogenic ingredients injected directly into the bloodstream and lymphatics not only bypassing but also compromising many of our body's immune system defenses and entering easily into the brain. To allow this vaccination to take place would be to disobey God’s order for me and My Class to protect God’s Temple inside of us as noted herein.

As to a Physician Right to Issue Vaccine Medical Exemptions based on Conscience and 5 As used herein, “I”, “Me”, “My”, “Individual” and “Person” mean a man or woman of flesh and blood, a Child of God, and not a government-created fictitious or artificial entity.

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Religious Freedom Beliefs

This conscience and religious right and responsibility, and the free exercise thereof, includes a physician, medical assistant, nurse, and medical establishment personnel’s (hereinafter “Medical Professional”) right to exercise their professional medical discretion based on the exercise of their conscience and religious beliefs, rights6 and freedom, based on their own study and personal experience, including but not limited to the following:

1. A Medical Professional’s right to issue a medical exemption for any or all vaccines permanently to his patients, child or adult, if such medical professional believes that the toxic and other chemical ingredients contained in vaccines (individually, synergistically or in combination with other vaccines) can be harmful to their patient(s) in any way, up to and including serious disability such as autism and even death.

There is no medical evaluation, procedure or exam that can indisputably prove 100% of the time that such vaccines will cause or not cause such injury to the child and individual receiving the vaccine. Even vaccine manufacturers declare in their vaccine inserts that persons susceptible to the ingredients of their vaccines should not be vaccinated with such particular vaccines. If there is no way to tell if the vaccine will harm such child or person, it is always better to err on the side of caution.

2. A Medical Professional’s right to issue a medical exemption to any of his/her patients based on both (a) the medical professional’s conscience and religious freedom rights to consider vaccines potentially unsafe for their patient’s, as well as (b) the medical professional’s obligation to respect his/her patient’s conscience and religious freedom rights to avoid vaccination, due to the patient’s belief of the potential dangers of vaccines, which beliefs are similar to those of the Medical Professional’s personal and religious beliefs of such vaccine dangers.

3. A Medical Professional’s right to apply his medical knowledge and personal medical experience to make a personal Conscience decision, based on his ethical and moral Conscience beliefs, and to issue a medical exemption for that child knowing that any vaccine can seriously injure or kill any child, without their being any prior existing signs that such child might be susceptible to a certain vaccine and its ingredients, especially when receiving a combination of vaccines at the same time.

A more detailed explanation on the foundation of such belief in vaccine harm will be explained below.

BIBLICAL AUTHORITY TO AVOID VACCINATION

6 The physician’s medical responsibility is not only limited to a physician’s Hippocratic Oath that requires such physician to swear to and uphold specific moral and ethical standards, whose primary rule is "First do no harm" (also expressed as “Practice two things in your dealings with disease: either help or do not harm the patient"; see Lloyd, Geoffrey, ed. [1983], Hippocratic Writings [2nd ed.], London: Penguin Books. p. 94.); but also as a God-given commandment to do no harm, when in the Holy Bible’s Sixth Commandment God says “You Shall Not Murder”, and in the Ninth Commandment God declares, “You shall not give False Testimony against your Neighbor. These Commandments are summarized in Luke 6:31, where it says, ““And as yee would that men should doe to you, doe yee also to them likewise.”

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In the Holy Bible7 such rights to avoid vaccination to protect one’s own body and that of all persons under their care, as well as to reject any governments rules contrary to such God-given religious rights and obligations are clearly stated in the following Biblical verses:

“Knowe yee not that yee are the Temple of God, and that the Spirit of God dwelleth in you?”

1 Corinthians 3:16

“If any man defile the Temple of God, him shall God destroy: for the Temple of God is holy, which Temple ye are.”

1 Corinthians 3:17

“What, know ye not that your body is the Temple of the holy Ghost which is in you, which yee haue of God, and ye are not your owne?”

1 Corinthians 6:19

“Neither shall they say, Loe here, or loe there: for behold, the kingdome of God is within you.”

Luke 17:21

“And whosoeuer shall offend one of these litle ones that beleeue in me, it is better for him, that a milstone were hanged about his necke,

and he were cast into the Sea.”Mark 9:42

“Loe, children are an heritage of the Lord: and the fruit of the wombe is his reward.”

Psalm 127:3

“Who will rise vp for mee against the euill doers? or who will stand vp for me against the workers of iniquitie?”

Psalm 94:16

“It is an abomination to kings to commit wickednesse: for the throne is established by righteousnesse.”

Proverbs 16:12

“If a ruler hearken to lies, all his seruants are wicked.”Proverbs 29:12

“Enter not into the path of the wicked, and goe not in the way of euill men.”

Proverbs 4:14

MY CONSCIENCE, MORAL AND RELIGIOUS BELIEFS ARE AGAINST ABORTION IN ANY FORM AND I REFUSE TO PARTICIPATE IN IT7 I adopt herein by reference and incorporation the 1611 King James Version of the Holy Bible.

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When HHS Civil Rights Division Director Roger Severino did the public announcement pertaining to the new CRF Division (see https://tinyurl.com/HHS-CRFD-Severino), he and other members of the panel discussed how medical practitioners, from doctors to nurses, should not be forced to participate in any procedure related to abortion if it was against (a) their conscience beliefs, and or (b) their religious beliefs.

In my particular case, I, my religion, and my religious beliefs are firmly against abortion in all ways, shape and form, and therefore I am against vaccines because, among other things, they contain fetal cells/matter, which comes from aborted fetus, which is a result of murder. Many, if not the majority of or all vaccines contain fetal cells and matter, and the new generation of vaccines will contain such materials. This can be easily confirmed not only reviewing the vaccine manufacturer’s data on such vaccine components listings, but it can be easily summarized by pro-vaccine activist Paul Offit, the Director of the Vaccine Education Center from the Children’s Hospital of Philadelphia, who works in close coordination with the CDC in promoting vaccines. In the following video by Offit he confirms that vaccines contain fetal cells/matter. See https://tinyurl.com/PaulOffit-FetusInVaccines .

See also information on the new human diploid cell line of vaccines, at https://tinyurl.com/Vaccines-Diploid-Cells. If the HHS Conscience and Religious Freedom Division will actively work to protect and defend such medical practitioners’ rights to not participate in any way with abortion, then the CRF Division must protect and defend my position against vaccines simply due to the vaccine’s content of fetal cells and matter, being that I am against abortion and will not participate in abortion-related procedures, abortions being against my firmly held religious beliefs, as to abort a child is to kill a child of God, and I would be participating in such murder by using such vaccines. It is written in the Bible:

“For thou hast possessed my reines: thou hast couered me in my mothers wombe. I will praise thee, for I am fearefully and wonderfully made, marueilous are thy works: and that my soule

knoweth right well.”Psalm 139:13-14

“Though shall not Kill”Exodus 20:13

ASSERTING THE SUPREMACY OF MY WILL As noted in the famous and often cited vaccine case Jacobson v. Massachusetts, 197 U.S. 11 (1905), “There is, of course, a sphere within which the individual may assert the supremacy of his own will, and rightfully dispute the authority of any human government, especially of any free government existing under a written constitution, to interfere with the exercise of that will.”

I hereby declare and assert the supremacy of my will over any and all human and earthly governments, as I Am A Child of God and Not A Child of The State, including my

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supremacy as regards my religious beliefs, freedom, rights and actions to opposed and to not vaccinate my children and to not participate in abortion, and dispute the authority of the State of California, it’s legislature, it’s judicial branch, and its executive agencies to interfere with the exercise of my will as regards my religious beliefs, freedom and rights in general, including the right to have my daughter Annette Beas attend school without receiving any SB 277 required vaccines, now or in the future.

LISTING OF COMPLAINT’S CRIMINAL PARTICIPANTS

As noted in the title of this Vaccine Religious Freedom Class Action Complaint, the Criminal Participants who are violating my and our conscience and religious rights and freedom are, among others, as follows:

(1) School Superintendent, name and title; District name, city, state(2) California Senator Richard Pan;(3) California Governor Jerry Brown; and(4) Any and all other persons and parties, as man or woman or as government-created

fictitious entities and their agents, participating and colluding in any way, knowingly or unknowingly, in the unconstitutional application of SB 277.

I declare herein that the above referenced Criminal Participants, including School District Superintendent first and last name, Senator Pan and Governor Brown, individually and in conjunction with other Criminal Participants8 violated my conscience and religious freedom rights through (1) their actions in authoring and promoting California Senate Bill 277 (SB 277), (2) by passing legislation to approve it, (3) by having Governor Brown sign its approval as valid legislation, (4) by having California school districts enforce it by not allowing unvaccinated children to attending school, (5) by having school and health department officials take actions to pressure doctors not to issue vaccine medical exemptions based on their medical experience, conscience and religious freedom rights and beliefs, and (6) through such school authorities and health departments’ harassment of parents when such parents present such medical exemptions, as well as when such parents submit their own “Personal and Religious Beliefs Exemption Notification Letter” or the like in order to attend school, regardless of when submitted, often refused by school officials, this being in clear violation of my and My Class’s conscience and religious rights as spelled out in the First Amendment of the U.S. Constitution.

SB 277 DOES NOT ELIMINATE THE RELIGIOUS EXEMPTION TO VACCINATION

According to the Criminal Participants, SB 277 removes the religious exemption for a child to attend school without all the allegedly mandated school vaccinations; but the reality is that neither SB 277 nor its predecessor, Assembly Bill 2109 (AB 2109) even mention religious exemptions, nor do they mention limitations to a child’s right to religious freedom and to avoid vaccination based on those grounds, regardless of the fact that the authors of SB 277, AB 2109, and even the 1961 Assembly Bill 1940 make it appear that mentioning “personal rights” is equivalent to “religious rights”, which clear distinction between the two is made in several Supreme Court cases, including by not limited to Jacobson v. Commonwealth of Massachusetts,

8 See Ricardo Beas’ Vaccine Class Action Complaint mailed and emailed on or around July 2, 2017 to the Civil Rights offices of the U.S. Department of Justice, U.S. Department of Health & Human Services, and the U.S. Department of Education, filed by such executive departments under the following reference numbers: DOJ I.D. # DJ 144-11-0; HHS TRANSACTION # 17-277069; and DOEd CASE # 09-17-1609. I adopt herein by reference and incorporation Mr. Beas’ Vaccine Class Action Complaint.

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197 U.S. 11, 27–29 (1905), and Bruesewitz v. Wyeth LLC, 131 S. Ct. 1068, 179 L. Ed. 2d 1 (2011).

Therefore, the religious exemption is still valid in California and can still be used by parents to reject vaccination for their children in order to attend school. The California legislature could have clearly included such a religious statement “supposedly” removing such right, but failed to do so, and I contend that they did so on purpose to mislead parents and the public at large.

HHS FEDERAL REGISTER PROPOSAL TO MODIFY FEDERAL REGULATIONS TO REFLECT CONSCIENCE AND RELIGIOUS FREEDOM RIGHTS

In the HHS January 26, 2018 Federal Register proposed rules for changes to certain applicable federal regulations to conform with and reflect a person’s conscience and religious freedom rights it notes that such regulations should not “compel a person to undergo medical screenings, examination, diagnosis, treatment, health care or services if a person objects on religious grounds.” This includes not being compelled to vaccinate one’s children if against such conscience and religious freedom rights.

While such statement is qualified by stating that an exemption to the above can be based on “discovering and preventing the spread of infection or contagious disease or protecting environmental health”, the evidence shows that unvaccinated children have as much or less of a likelihood of infecting other children, vaccinated or not.9 Therefore, unvaccinated children do not pose any additional danger to other children to justify such child being forced to be vaccinated as required by SB 277 in order to attend school.

While the HHS Federal Register proposal notes that “Given these provisions, it is no surprise that, as described supra, in Part VIII, all fifty States have some protections in place for conscientious objectors to certain health or medical services”, California and other states have illegally eliminated such personal and religious protections for their inhabitants as regards vaccination.

APPLICABILITY OF CONSCIENCE AND RELIGIOUS FREEDOM RIGHTS FOR ALL PERSONS IN MY CLASS: “ANTI-MANDATORY VACCINE ADVOCATES”

In the recent HHS announcement of January 18, 2018 by Director of Civil Rights Roger Severino regarding the newly formed Conscience and Religious Freedom Division (CRF) it was made clear by him and the other speakers, including U.S. Senator James Lankford, that individuals and persons can file claims for themselves and for others with the CRF if those person’s conscience and religious freedom rights are violating.

While the focus of the announcement was conscience and religious rights as apply to medical abortion procedures, it is clear by the words of Director Severino that the HHS, and the federal

9 See the Proceedings of the National Academy of Sciences of the United States of America's (PNAS) “Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community”, a study proving that 630% more “aerosolized flu virus particles” are emitted by people who received flu shots. See also study that shows that vaccinated children are sicker than unvaccinated children, at http://healthimpactnews.com/2011/new-study-vaccinated-children-have-2-to-5-times-more-diseases-and-disorders-than-unvaccinated-children/. See also immunologist Tetyana Obukhanych’s observations noting that vaccinated children spread more disease than unvaccinated children, at https://www.healthnutnews.com/harvard-immunologist-unvaccinated-children-pose-zero-risk/. See also New York Times article, “Mumps Makes a Comeback, Even Among the Vaccinated”, at https://www.nytimes.com/2017/11/06/well/family/mumps-makes-a-comeback-even-among-the-vaccinated.html.

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government in general, such as other executive departments including the DOJ and the DOEd, have a responsibility under their own jurisdiction and authority to investigate and take action, including working together, to protect such persons’ religious rights without government and its agent’s interference.

The Conscience and Religious Freedom Division’s announcement also makes it clear that the abortion issue and the violation of conscience and religious rights of certain medical professionals and staff against abortion is substantial, not a few persons here or there, which made it necessary to create such a Division and to make such public announcement so that HHS could do its best to get the word out that this is a systemic conscience and religious rights violation problem that must be addressed and that all affected persons have to be aware of so they can take advantage of the HHS complaint process.

In the same manner, it is undeniable and known that thousands of persons, from California and all across our nation are against forced vaccination, and that many of them have children, family and friends, even themselves, which have been injured buy such vaccines in various ways, including death and some mothers’ spontaneous abortion after vaccination.10

People such as myself, My Class, all of us Children of God, are not against other people being vaccinated if they wish to do so for themselves or their children; but we are against being forced to inject or introduce into our bodies and that of our children any and all toxic ingredients in vaccines.

Me and My Class have been classified by the Criminal Participants as a group of uninformed anti-vaccination activist, but in reality we are simply Anti-Mandatory Vaccine Advocates, and all of us, as such Class of Anti-Mandatory Vaccine Advocates, are having our conscience and religious freedom rights violated as described herein.

Therefore, while the PDF form and electronic form created by the CRF requests that whomever submits a complaint for another person identify that person by name, address and phone number, the CRF, as well as the DOJ and DOEd civil rights departments must address this matter by working together and looking at these violations of conscience and religious rights not only on a case-by-case basis, but also in a global sense to protect all those tens, if not hundreds of thousands of persons whose conscience and religious rights are being violated daily through government, medical and media misinformation, false pretenses, fraud and under duress and coercion by school administrators; all of this harassment from the Criminal Participants because of me and My Class’ conscience and religious beliefs and subsequent decision to not vaccinate our children, which vaccines we consider toxic and potentially life altering and deadly as the evidence and DOJ/HHS/DOEd records shows.11

10 See the website by the producers of the film “Vaxxed – From Cover-up to Catastrophe, where more than 6,800 persons have submitted their stories of vaccine injury, at http://www.vaxxed.com/home/. See HHS Vaccine Class Action Complaint, supra and infra; The Vaccine Program: Betrayal of Public Trust & Institutional Corruption. Part 1 of 7, at https://tinyurl.com/WMP-VaccineProgram-Betrayal; “The Vaccine Court: The Dark Truth of America’s Vaccine Injury Compensation Program”, by Wayne Rohde. See also “Vaccine Villains: What the American Public Should Know about the Industry”, by Robert F. Kennedy Jr. and Anne Dachel. See also phone call between Kennedy and CDC’s Paul Offit admitting vaccine harm, at https://www.facebook.com/hashtag/offitforprofit?source=feed_text.11 See “Vaccine Class Action Complaint” filed with HHS Civil Rights office, supra, redacted at http://tinyurl.com/Vaccine-Class-Action-Complaint. See also reply to DOJ after their Civil Rights Division Section’s Chief Tamara J. Kessler denied and refused to investigate such complaint also submitted to them, at http://tinyurl.com/Vaxx-Class-Action-Reply-1 and http://tinyurl.com/VCAC-Reply-1-Exhibits.

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Me and My Class’ conscience and religious freedom rights must be protected by the civil rights divisions of the DOJ, HHS and DOEd, working in unison, from such intrusion into our lives and our religious right to practice our religion in a way that we believe will better protect our children’s health, while complying with God’s ordained responsibility placed upon all parents, while ensuring that our children will not be denied public or private schooling for lack of vaccination.

HHS, DOJ and DOEd must take action on this Vaccine Religious Freedom Class Action complaint I am submitting now and must allow others to join my complaint where they can identify, as I will here, themselves and those they represent and their own specific circumstances and situations, where their conscience and religious freedoms have been violated for their decision either to not vaccinate their children, or in the case of an authorized physician, for issuing a vaccine medical exemption for any or all alleged SB 277 mandated vaccines based on their conscience and religious belief that vaccines are both toxic and that they defile our body, God’s Temple, as noted above. To not take action now to neutralized SB 277 as regards me and My Class, risks our children’s (1) loss of school privileges, and or (2) possible vaccine injury to the child, especially when never vaccinated and then ordered to catch up with the SB 277 vaccine schedule, receiving 5 to 10 vaccines at the same time.

CAVEAT: It is the involved government agent reader’s duty to comply with their oath of office, which official responsibility includes not violating and not allowing other government officials to violate my and My Class’s conscience and religious freedom rights. Failure to do so can result in loss of immunity and in a personal liability suit against you under tort law.

JURISDICTION

The DOJ, HHS and DOEd have jurisdiction to investigate this matter, to work together and to take legal action against all Criminal Participants named herein, to wit,

U.S. Department of Health and Human Services

The HHS Conscience and Religious Freedom Division has jurisdiction and can investigate any and all matters related to violations of conscience and religious freedom rights regarding a parent’s decision not to vaccinate their children, such as in the following circumstances:

(1) HHS’ jurisdiction includes assisting and protecting the rights of those persons who presently receive any benefits under the jurisdiction of the U.S. Department of Health and Human Services (HHS) as covered under Section 508 of the Social Security Act (42 USC § 708), Section 533 of the Public Health Service Act (42 USC § 290cc-33); Section 1908 of the Public Health Service Act (42 USC §300w-7); Section 1947 of the Public Health Service Act (42 USC § 300x-57); The Family Violence Prevention and Services Act (42 USC § 10406); The Communications Act of 1934 (47 USC § 398); and any other related federal laws, legislation and regulations (hereinafter “regulations”).

(2) HHS’ jurisdiction includes assisting and protecting the rights of those persons who are medical professionals, including (a) physicians that are harassed by the medical establishment and health authorities for issuing vaccine medical exemptions under the physician’s conscience and religious freedom belief as described herein; and (b) nurses who see vaccine injury in the emergency room or in their department and they are

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harassed into not telling others of their belief in the vaccine injury, as well as are prohibited from suggesting the injury be reported in the federal database known as the Vaccine Adverse Event Reporting System (VAERS), or that the nurse report such injury in the VAERS database on his or her own.

(3) HHS has jurisdiction to investigate and take action against any medical establishment and government agency and their respective agents, in particular those receiving funds from HHS directly or indirectly in the form of tangible or intangible things of value, if such medical establishment or government agency, or any covered entity violates any person’s, employees’, or medical professional’s conscience and religious freedoms rights and beliefs.

(4) HHS has jurisdiction to investigate and take action against any public or private school, school district, county health department, and state department of education, in particular those receiving funds from the HHS directly or indirectly in the form of tangible or intangible things of value, such as funds for nutrition and school breakfast programs, school materials, literature and books, and any and all other tangible and intangible benefits from HHS, if such entity violates any person and his children’s conscience and religious freedoms rights and beliefs.

See Exhibit 2, correspondence from the involved school district confirming that they are directly or indirectly recipients of public funds from HHS and other federal agencies.

(5) For most of the laws enforced by HHS, a “Covered Entity” must receive, directly or indirectly through any other entity Federal financial assistance from the U.S. Department of Health and Human Services.

(6) At a minimum, HHS has an obligation to refer and report this violation of my and My Class’ conscience and religious freedom rights to DOEd and HHS.

(7) The whole issue of mandatory vaccination for children comes precisely from HHS’ own CDC recommendations for school vaccinations based on the CDC’s schedule. But these are not just CDC recommendations, they push this agenda to make childhood vaccines mandatory to the states and to the organizations the CDC funds, such as the National Association of County and City Health Officials (NACCHO), all of which together with the CDC are pushing state legislators, health and educational institutions to remove the personal and religious exemptions from any legislation dealing with elementary school vaccination. Therefore, HHS has jurisdiction and an obligation to investigate and take action in this matter because of the rouge actions by the CDC in promoting toxic vaccines, which CDC whistleblower Dr. William Thompson has come out to confirm that the CDC has fraudulently hidden and destroyed documents that show all the dangers of vaccines, in particular their link to autism.

U.S. Department of Education

The U.S. Department of Education Civil Rights office has jurisdiction and can investigate any and all matters related to violations of conscience and religious freedom rights regarding a parent’s decision not to vaccinate their children, such as in the following circumstances:

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(1) DOEd has jurisdiction to investigate and take action against any public or private school, school district, county health department, and state department of education if such entity violates any person and his children’s conscience and religious freedoms rights and beliefs, and such actions result in a child’s loss of right to attend public or private school.

Discrimination on the basis of race, color, and national origin is prohibited by Title VI of the Civil Rights Act of 1964. This includes discrimination based on a person’s limited English proficiency or English learner status; and actual or perceived shared ancestry or ethnic characteristics, including membership in a religion that may be perceived to exhibit such characteristics, such as Christian, Jewish or Muslim.

(2) DOEd has jurisdiction to investigate and take action against any public or private school, school district, county health department, and state department of education if such entity violates any person and his children’s conscience and religious freedoms and beliefs, and such school or named entity receives any funds directly or indirectly from HHS, such as funds for nutrition and school breakfast programs, school materials, literature and books, and any and all other tangible and intangible benefits from DOEd.

(3) At a minimum, DOEd has an obligation to refer and report this violation of my and My Class’ conscience and religious freedom rights to DOJ and HHS.

U.S. Department of Justice

The United States Department of Justice’s Civil Rights Division, the primary federal agency for the protection and prosecution of any person or entity for violation of civil rights, including conscience and religious freedom rights and beliefs, has jurisdiction and can investigate any and all matters related to violations of conscience and religious freedom rights regarding a parent’s decision not to vaccinate their children, such as in the following circumstances:

(1) The DOJ has the authority to investigate and prosecute the perpetrators of any crime related to interstate commerce dealing with fraud, mail fraud, harassment, inflicted injury, murder (knowing or unknowingly), racketeering, extortion, conspiracy to commit a crime in any of the prior listed activities, as well as violations of conscience and religious freedom rights, among other things.

(2) The DOJ Civil Rights Division’s Educational Opportunity Section has the authority to investigate and prosecute any person or school entity, public or private, receiving any federal funds for any activity, who violates any person’s conscience and religious freedom rights.

(3) The DOJ has the authority to investigate and prosecute any person or entity violating a person’s conscience and religious rights if such violation results in the loss of school rights and privileges, to wit,

No person shall on the ground of sex or religion be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with funds made available by the federal government, including but not limited to funds for nutrition and school breakfast programs, school materials, literature and books, field trips, awards, vouchers of any type, and any and all other tangible and intangible things and benefits from the federal government.

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The above regulations, jurisdiction and responsibility referenced above for HHS, DOJ and DOEd give and establish authority for HHS to take any necessary legal action, to ensure that No person shall on the ground of his or her religion be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with funds made available under the HHS, DOJ and DOEd’s jurisdiction. This includes the right to attend elementary and secondary schools, as well as public colleges and universities without vaccination based on conscience and religious freedom rights.

This HHS authority and legal responsibility and obligation include reporting to the U.S. Attorney General and the DOJ Civil Rights division, about such violation of my and My Class’ rights as noted herein. In their website HHS states,

“The HHS mission is to enhance and protect the health and well-being of all Americans. We fulfill that mission by providing for effective health and human services and fostering advances in medicine, public health, and social services.”

INTERDEPARTMENTAL AGENCIES’ OBLIGATION TO WORK TOGETHER

The DOJ, HHS and DOEd are all federal executive branch agencies/departments, under one general obligation, which is to provide services to the general population of the nation as enumerated in the U.S. Constitution. Among those responsibilities it includes to ensure that a person’s constitutional rights, including personal, conscience and religious rights, are not violated by any person, fictitious entity such as corporations, nor by any other government department and their agents.

The federal government, as well as all local, county and state governments, de facto or de jure, are bound by the U.S. Constitution and cannot violate any of my and My Class’s rights as noted in the various amendments therein, to wit,

(1) 1st Amendment: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.”

NO ENTITY OR PERSON CAN VIOLATATE MY OR MY CLASS’ CONSCIENCE AND RELIGIOUS FREEDOM RIGHT NOT TO VACCINATE OUR CHILDREN;

(2) 4th Amendment: “The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated.”

ME AND MY CLASS HAVE A RIGHT TO BE SECURE OF OUR PERSONS, WHICH INCLUDES OUR HEALTH AND THAT OF OUR FAMILY AND CHILDREN, AND THEREFORE NO ENTITY OR PERSON HAS THE RIGHT OR AUTHORITY TO HARM US IN ANY WAY, INCLUDING BUT NOT LIMITED TO (a) FORCING US TO USE TOXIC VACCINES, (b) THREATENING TO DENY SCHOOL FOR OUR CHILDREN, (c) HARRISING US OR OUR CHILDREN FOR NOT VACCINATING, (d) TAKING OUR CHILDREN AWAY FROM US FOR LACK OF VACCINTAION, AND (e) TAKING LEGAL OR ILLEGAL ACTION AGAINST US FOR SUCH CONSCIENCE AND RELIGIOUS DECISION TO NOT VACCINATE OUR CHILDREN. THE SAME APPLIES TO MEDICAL PROFESSIONALS.

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(3) 5th Amendment: “No person shall … be deprived of life, liberty, or property, without due process of law.”

THE ACTIONS OF THE CRIMINAL PARTICIPANTS CAN, WILL, OR ARE DEPRIVING ME OF MY CHILDS RIGHT TO A HEALTHY LIFE BY ATTEMPTING TO FORCE US TO GIVE OUR CHILDREN TOXIC INGREDIENTS IN VACCINES DIRECTLY INTO THEIR BLOODSTREAM. FURTHER, THE CRIMINAL PARTICIPANTS ARE ALSO INPINGING ON OUR RELIGIOUS FREEDOM TO TAKE OUR CHILDREN TO A SCHOOL OF OUR CHOICE WITHOUT HAVING TO BE FORCED TO VACCINATE THEM. ALSO THEY ARE AFFECTING MY PROPERTY IN THE FORM OF EXPENSES RELATED TO TIME INVESTED IN THIS FIGHT FOR MY CONSCIENCE AND RELIGIOUS RIGHTS AND FORCING US TO HOME SCHOOL OUR CHILDREN AT OUR EXPENSE, WHILE BEING TAXED TO CONTRIBUTE TO THE PUBLIC EDUCATIONAL SYSTEM.

(4) 8TH Amendment: “Excessive bail shall not be required, nor excessive fines imposed, nor cruel and unusual punishments inflicted.”

THE INVOLVED CRIMINAL PARTICIPANTS ARE INFLICTING CRUEL AND UNUSUAL PUNISHMENT AGAINST US AND OUR CHILDREN IN THE FORM OF (a) DEPRIVATION OF EDUCATION, WHICH CAN LEAVE A CHILD BEING COMPLETELY UNPREPARED TO FACE LIFE AND ITS OBLIGATIONS, AND (b) BY TRYING TO FORCE US THROUGH THREAT OF PUNISHMENT IN THE FORM OF DENIED SCHOOLING TO HAVE OUR CHILDREN VACCINATED AGAINST OUR WILL, WHICH CAN RESULT IN SERIOUS INJURY, SUCH AS ENCEPHALITIS, GUILLAIN-BARRÉ SYNDROME, SUDDEN INFANT DEATH SYNDROM, SERIOUS AUTISM AND EVEN DEATH, AS NOTED IN THE VACCINE MANUFACTURERS OWN VACCINE INSERTS.12

(5) 9th Amendment: “The enumeration in the Constitution of certain rights shall not be construed to deny or disparage others retained by the people.”

THE U.S. CONSTITUTION, WHICH OTHER STATES’ CONSTITUTIONS REFLECT AND WHERE SUCH STATE’S AUTHORITY COMES FROM, NEVER MENTIONS NOR GIVES THE RIGHT TO ANY GOVERNMENT, THEIR AGENTS, OR ANY FICTITIOUS ENTITY CREATED UNDER IT, TO FORCE ME OR MY CHILDREN TO UNDERGO ANY MEDICAL PROCEDURE AGAINST OUR WLL, IN PARTICULAR WHERE OUR CHILDREN DO NOT SHOW ANY SIGNS OR SYMPTOMS OF MINOR OR SERIOUS DISEASE AS ARE PURPORTED TO BE CONTROLLED BY SUCH CHILDHOOD VACCINES.

(6) 10th Amendment: The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

NEITHER THE FEDERAL OR STATE GOVERNMENTS HAVE CONSTITUTIONAL AUTHORITY TO FORCE ME TO VACCINATE MY CHILDREN AND RISK

12 See study describing all vaccine dangers noted in such vaccine inserts, compared to the CDC’s vaccine flyers which omit all such dangers, noting that in the majority of the cases when you go to a physician’s office and you request the insert all they give you is the CDC flyer, at http://tinyurl.com/Vaccine-Insert-Analysis.

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POTENTIAL VACCINE INJURY AGAINST MY CONSCIENCE AND RELIGIOUS FREEDOM BELIEFS AND RIGHTS.13

EXAMPLE OF A FEDERAL AGENCY PROTECTING A MAN AND OR A WOMAN FROM BEING VACCINATED AGAINST THEIR CONSCIENCE AND RELIGIOUS FREEDOM RIGHTS – MANDATORY VACCINES IN HOSPITAL SETTINGS.

U.S. EEOC v. Saint Vincent Health Center, Civil Action No. 1:16-cv-234

As noted in an AP article dated Sept. 26, 2016,14 Federal authorities sued a Pennsylvania hospital, Saint Vincent Hospital, alleging religious discrimination in the firing of six employees who refused to get flu shots.

The lawsuit was filed in federal court in Erie, Pennsylvania by the U.S. Equal Employment Opportunity Commission (EEOC) against Saint Vincent Hospital, which was founded by the Sisters of St. Joseph of Northwestern Pennsylvania. The commission claimed that Saint Vincent violated Title VII of the Civil Rights Act of 1964.

Beginning in October 2013, the hospital required employees to get flu shots unless they were granted an exemption on medical or religious grounds, in which case they were required to wear a face mask. The suit alleges that six employees who refused to get flu shots due to their religious beliefs were fired, while the hospital granted medical exemptions to 14 others in late 2013 and early 2014.

As noted by Plaintiff’s attorney Debra Lawrence, “the legal standard isn’t whether officials agree with the religious beliefs “or whether those beliefs are the recognized position or official doctrine of any particular religious organization or group. Absent proof establishing an undue hardship, federal law requires an employer to provide reasonable accommodations for sincerely held employee religious beliefs, even if some may consider those beliefs idiosyncratic.”

As noted in the EEOC website,

“In addition to requiring monetary relief and offers of reinstatement for the six employees, the consent decree contains multiple injunctive components.

13 See California Constitution as an example. Article 1, section 4 states: “Free exercise and enjoyment of religion without discrimination or preference are guaranteed.” Article 1, section 1 states: “ALL PEOPLE ARE BY NATURE FREE AND INDEPENDENT AND HAVE INALIENABLE RIGHTS. AMONG THESE ARE ENJOYING AND DEFENDING LIFE AND LIBERTY, ACQUIRING, POSSESSING, AND PROTECTING PROPERTY, AND PURSUING AND OBTAINING SAFETY, HAPPINESS, AND PRIVACY.” Article 9, section 1 states: “A general diffusion of knowledge and intelligence being essential to the preservation of the rights and liberties of the people, the Legislature shall encourage by all suitable means the promotion of intellectual, scientific, moral, and agricultural improvement.” Article 9, section 5 states: “The Legislature shall provide for a system of common schools by which a free school shall be kept up and supported in each district at least six months in every year, after the first year in which a school has been established.” Article 1, section 7 states: “A person may not be deprived of life, liberty, or property without due process of law or denied equal protection of the laws.” 14 See “Hospital sued over firing of employees who refused flu shots”, at https://apnews.com/647a64786f9c447181bdf9e30862216a/hospital-sued-over-firing-employees-who-refused-flu-shots. See also http://www.goerie.com/news/20161221/erie-hospital-to-pay-rehire-ex-workers-who-refused-flu-shots. See also https://www.eeoc.gov/eeoc/newsroom/release/12-23-16.cfm.

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Under the decree, if the Health Center chooses to require employee influenza vaccination as a condition of employment, it must grant exemptions from that requirement to all employees with sincerely held religious beliefs who request exemption from the vaccination on religious grounds unless such exemption poses an undue hardship on the Health Center's operations, and it must also notify employees of their right to request religious exemption and establish appropriate procedures for considering any such accommodation requests.

The decree also requires that when considering requests for religious accommodation, the Health Center must adhere to the definition of "religion" established by Title VII and controlling federal court decisions, a definition that forbids employers from rejecting accommodation requests based on their disagreement with an employee's belief; their opinion that the belief is unfounded, illogical, or inconsistent in some way; or their conclusion that an employee's belief is not an official tenet or endorsed teaching of any particular religion or denomination.”

Ultimately, on or around December 22, 2016, the hospital rehired the employees, gave them back pay, compensation damages and reinstated them to their previous position.

EEOC v. Mission Hospital, Inc., Civil Action No. 1:16-CV-00118

As noted in the EEOC website,15 Mission Hospital, Inc., a North Carolina corporation based in Asheville, violated federal law when it failed to accommodate employees' religious beliefs and fired them because of their religions. According to EEOC's complaint, Mission Hospital requires employees to receive a flu vaccination annually by no later than December. An employee may request an exemption to the vaccination requirement based on religious beliefs, but the hospital requires that the request be made by Sept. 1, or it is subject to being denied.

Title VII of the Civil Rights Act of 1964 requires employers to make a reasonable accommodation for an employee's sincerely held religious beliefs as long as doing so does not pose an undue hardship on the employer.

"Under federal law, employers must attempt a fair balance between an employee's right to practice his or her religion and the operation of their business, said Lynette A. Barnes, regional attorney for EEOC's Charlotte District Office. An arbitrary deadline does not protect an employer from its obligation to provide a religious accommodation. An employer must consider, at the time it receives a request for a religious accommodation, whether the request can be granted without undue burden. This case demonstrates EEOC's commitment to fighting religious discrimination in the workplace."

Similarities Between Hospital Cases and SB 277 Legislation

In the text of SB 27716 it states that “The bill would allow pupils who, prior to January 1, 2016, have a letter or affidavit on file at a private or public elementary or secondary school, child day care center, day nursery, nursery school, family day care home, or development center stating beliefs opposed to immunization, to be enrolled in any private or public elementary or secondary

15 See https://www.eeoc.gov/eeoc/newsroom/release/4-28-16.cfm. 16 https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277

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school, child day care center, day nursery, nursery school, family day care home, or development center within the state until the pupil enrolls in the next grade span.” An example under SB 277 include (a) a child entering school for the first time that did not submit a child’s letter or affidavit by January 1, 2016, and (b) a child moving from 6th grade to 7th grade.

Such legislation violates the idea and applicable law noted in the hospital cases, in that “"An arbitrary deadline does not protect a school or school district from its obligation to provide a religious accommodation.” That is exactly what California schools and school districts are doing, violating a man, woman and or child’s right to claim their conscience and religious freedom rights at any time to attend school.

The above hospital cases are a clear example that federal government departments and agencies, such as HHS, DOJ and Doe have an obligation to protect me and My Class from the conscience and religious freedom discrimination we are facing due to SB 277.

PREVIOUS COMPLAINTS RELATED TO VIOLATION OF CONSCIENCE AND RELIGIOUS FREEDOM RIGHTS

Mr. Ricardo Beas submitted a complaint regarding the violation of his and My Class’ personal, medical, conscience and religious belief rights referencing SB 277 to the U.S. Department of Health and Human Services, Civil Rights Division on July 2, 2017. Such Vaccine Class Action Complaint was assigned by your department HHS TRANSACTION # 17-277069.

Such complaint is not only focused on my and My Class’ violation of conscience and religious rights, but also on the actual UNDER-REPORTED OCCURENCES OF VACCINE INJURY and how the Criminal Participants named herein, together with other Criminal Participants identified in Mr. Beas’ Vaccine Class Action Complaint, have manipulated medical organizations and establishment, mainstream media, and even government institutions, such as HHS’s Centers for Disease Control and Food and Drug Administration in order to force vaccination upon children and adults in our nation.

ALTERNATE AND EMERGENCY CONTACT

In case HHS’s is unable to contact me, please contact First and Last Name, at Address, City, State, phone # xxx-xxx-xxxx.

REMEDY REQUESTED

Based on the above I request that the appropriate civil rights departments from the HHS, DOJ and DOEd work individually and together to do the following:

1. Use your authority to the fullest extent of the law to investigate and take legal action to stop all named Criminal Participants, individually and their organizations from violating me and My Class’ conscience and religious freedom rights to attend school as regards the right to refuse any and all vaccination for our children based on our personal, medical, conscience, religious freedom and constitutional rights as protected by the First Amendment to the U.S. Constitution. Therefore, order the Criminal Participants to allow my child to attend school without the SB 277 required mandatory vaccinations .

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2. As soon as possible, but in no less than three months, have Secretary Roger Severino do another HHS announcement as that of January 18, 2018, declaring that HHS, individually and or in conjunction with DOJ and DOEd will also be enforcing conscience and religious freedom rights such as in the case of abortion procedures regarding mandatory school vaccination programs, policies, legislation and the like.

3. Act upon Ricardo Beas’ Vaccine Class Action Complaint and take legal action against all Criminal Participants named therein in the form of fines, forfeiture, and imprisonment, as the case may mandate.

4. Take action against the State of California and any other state of the Union who has either removed or made it appear as if they had removed a person’s conscience and religious freedom rights to determine if vaccination is safe for their school children and whether such child should get the vaccination, allowing the child to attend school regardless of vaccination status.

5. Any and all other remedy and relief which is appropriate under the circumstances.

CONSENT TO HHS COMPLAINT PROCEDURES (Consent Form for DOEd at end of document)

As a Complainant, I understand that in the course of the investigation of my complaint it may become necessary for OCR to reveal my identity or identifying information about me to persons at the entity or agency under investigation or to other persons, agencies, or entities.

• I am also aware of the obligations of OCR to honor requests under the Freedom of Information Act (FOIA). I understand that it may be necessary for OCR to disclose information, including personally identifying information, which it has gathered as part of its investigation of my complaint. Complaint Consent Form Page 1 of 2 HHS-700 (10/17) (BACK)

• In addition, I understand that as a complainant I am covered by the Department of Health and Human Services’ (HHS) regulations which protect any individual from being intimidated, threatened, coerced, retaliated against, or discriminated against because he/she has made a complaint, testified, assisted, or participated in any manner in any mediation, investigation, hearing, proceeding, or other part of HHS’ investigation, conciliation, or enforcement process.

I reviewed the HHS Conscience and Religious Freedom Complaint Form Package in its entirety, including the Complaint Consent form, and I declare that I have read, understand, and agree with its content and give permission to OCR to reveal my identity or identifying information about me in my case file to persons at the entity or agency under investigation or to other relevant persons, agencies, or entities during any part of HHS’ investigation, conciliation, or enforcement process.

DECLARATION STATEMENT

I declare that the facts herein stated are true, correct and complete, and are stated under the penalty of perjury pursuant to the laws of the State of California, to the best of my knowledge, beliefs and upon information.

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I further declare that this Vaccine Religious Freedom Class Action Complaint was submitted to the authorities listed above by mail17 and email on Month Day, Year.

Dated: Month Day, Year

RESPECTFULLY SUMITTED,

_______________________________ Your NameA Child of God

EXHIBIT #1

Remove this statement:Email Correspondence with School District and Superintendent

Denying Attendance without All Required vaccines or a medical exemption

17 Deposited in U.S. Mails. Certified Receipt Numbers: HHS # xxxx-xxxx-xxxx-xxxx-xxxx; DOJ # xxxx-xxxx-xxxx-xxxx-xxxx; DOEd # xxxx-xxxx-xxxx-xxxx. Rev11 -- © RBWorks

Addresses ---- HHS: Centralized Case Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F HHH Bldg., Washington, D.C. 20201; DOJ: U.S. Department of Justice Civil Rights Division, 950 Pennsylvania Avenue, N.W., Educational Opportunities Section, PHB, Washington, D.C. 20530; DOEd: Office for Civil Rights, 400 Maryland Avenue, SW, Washington, DC 20202-1100.

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SAMPLE

EXHIBIT #2

Remove this statement:School District Public Records Act Request

Confirming the School District’s Receipt of Federal Funds

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