[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]