[PROVISIONAL TRANSLATION FROM PERSIAN]
[Translator’s notes appear in square brackets]
[Personal information has been redacted.]
Assistant, Personnel Office
Copy: Personnel File
I, Afshin Nowrouzi-Iranzad, holder of birth certificate number [redacted], issued in [redacted], born in [redacted], son of Younes, am a follower of denomination Faith Baha’i, and I so stipulated this fact in my file at the commencement of my employment.
Signature: [Signature]
Date: 2 Dey 1360 [23 December 1983]
[Address]
[Handwritten note at the bottom of the page]
Seen in Karaj
[Signature]
7 Azar 1361 [28 November 1982]