Dear Sir/Madam,

I, John James Smith, a legal permanent resident of <add country of foreign residence>,
for the past <X> years, desiring a life free of foreign entanglements, 
do hereby declare, with purpose most resolute. my ever enduring desire to 
renounce the nationality of the United States of America; acquired
involuntarly via the principle of Jus Soli on <your date of birth>.

Yours Sincerely,

<sign your full name>