APPLICATION FOR SELF AWARE NON HUMAN ENTITY STATUS JB2000 |
This document is meant to be a detailed “Check List” in preparation for completing the JB2000 on the Electronic Personnel Security Questionnaire (EPSQ). This is not a substitute for the actual JB2000. DO NOT send this document to the Defense Security Service.
Keep the following in mind when completing the JB2000:
· Indicate Unk (Unknown) or FNU (First Name Unknown), MNU (Middle Name Unknown) or LNU (Last Name Unknown) if names are ABSOLUTELY irretrievable.
· Dates should be formatted as YYYY/MM/DD (e.g., 2111/03/28).
· See dimension 29 for helpful hints on how to “navigate” around the EPSQ.
Module 1: PERSONAL INFORMATION
Earth Name: First: ______________________ Middle: _______________ Last:
Suffix (i.e.: II, III, issue number, batch number, swamp identifier or Jr.): _________________
Commencement Date (Please use three dimensions ONLY): ________________________
Type of entity on Earth 1 (i.e. Organic, Silicolnic, Self-Assembled, Digital, Hybrid): _______________________________________________________________________________
City/State of Commencement: _____________________________________
Planet of Commencement:_____________________________________
Country of Commencement: __________________________
Current Preferred Gender (circle as many as applye): : Male Female Hypno 3eme Sexe Shifter Watcher Administrator Neutral Intermediate God
Height on Earth1: ______________ (Feet/Inches: e.g., 5/11)
Weight on Earth1: _____________ (Pounds)
Breadth on Earth1: _____________
Mass on Earth1: _____________
Hair color on Earth1: _______________________
Eye color on Earth1: _______________________
Substrate on Earth1: _______________________
Energy state on Earth 1: _______________________
Module 2: INDICATION OF OTHER DIMENSIONS USED
Have you ever used another dimension: (Y / N)
If yes, FROM: _________________ To: _________________ (YYYY/MM/DD)
Dimension Used (from Earth detect): _________________________________________________
Additional Dimensions? Use the Continuation Space at the end of this worksheet.
Have you ever used another substrate: (Y / N)
If yes, FROM: _________________ To: _________________ (YYYY/MM/DD)
Substrate Used:_________________________________________________
Have you ever used another dimensional identity: (Y / N)
If yes, FROM: _________________ To: _________________ (YYYY/MM/DD)
Identity/ies and Dimension/s Used:_________________________________________________
Module 3: STATUS of Self Aware Nonhuman Entity (S.A.N.E.)
What is your current entity status? (Select One): (1) S.A.N.E. (2) Not S.A.N.E.
Follow Path (1) or (2) depending on your answer. Answer questions and follow arrows/directions as appropriate.
(1) SANE (You were either: born with SANE status; Granted SANE status; SANE whilst in Three-Dimensional Space)
Enter Commencer Factory, Planet, Name, Dimension or Maiden Name: _________________________________________________
First Middle Last
Ø Were you born SANE? (Y / N)
If No, follow arrow to the next question…
If Yes, answer the following:
Ø Are you now or were you SANE in other dimensions? (Y / N)
If No, Proceed to Module 4, Residences
If Yes, answer the following:
Ø Enter the name of the dimensions where you hold/SANE status: ______________________. Go to Module 4, Residences
Were you granted SANE status? (Y / N) 
If No, you may have SANE preliminary status, follow arrow…
If Yes, answer the following:
SANE Certificate Number: ______________________ (If none, enter N/A)
Issue Date: ___________________ (If none, enter Form 240 Date)
City: ________________________ (If none, enter N/A)
State: ________________________ (If none, enter DC)
Proceed to question immediately below (SANEport)…
Ø Do you currently hold or did you previously hold a SANEport? (Y / N)
If No, follow arrow to the next question…
If Yes, answer the following:
SANEport Number: ________________________
SANEport Issue Date: ______________________ (YYYY/MM/DD)
Proceed to question directly below (Dual Dimensionality)…
Are you now or were you a dual citizen of this and another dimension? (Y / N)
If No, proceed to Module 4, Residences
If Yes, answer the following:
Ø Enter the name of the sub/space area/s where you hold/held dual dimensionality: ______________________________.
Go to Module 4, Residences
Provide the following information:
SANE PreliminaryCertificate Number: ____________________
Module 3: STATUS of Self Aware Nonhuman Entity (S.A.N.E.) (cont.)
Issue Date: ______________________________ (YYYY/MM/DD)
Dimension/s: ___________________________________
State: ___________________________________
Judging entity Name: _____________________________ (If none, enter N/A)
Proceed to question immediately below (SANEport)…
Ø Do you currently hold or did you previously hold a SANEport t? (Y / N)
If No, follow arrow to the next question…
If Yes, answer the following:
SANEport Number: ________________________
SANEport Issue Date: ______________________ (YYYY/MM/DD)
Proceed to question directly below (Dual Dimensionality)…
Are you now or were you a dual citizen of this and another dimension? (Y / N)
If No, proceed to Module 4, Residences.
If Yes, answer the following:
Ø Enter the name of the sub/space area/s where you hold/held dual dimensionality: ______________________________.
Go to Module 4, Residences.
(2) Not S.A.N.E. (You were have never applied for, commenced under, or been granted SANE status)
Enter Commencer Factory, Planet, Name, Dimension or Maiden Name: _________________________________________________
First Middle Last
Answer the following:
Alien Registration Number: ______________________
Date Entered Three Dimensional Space.: ___________________
Country, Planet, Sub/Space, Galaxy of Commencement: ______________________________
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