[Translator’s notes appear in square brackets]

[Personal information has been redacted.]


In the Name of God

Respected Deputy of the Organization

This is to advise that Mrs. Afagh Morad-Ali, the spouse of the deceased Rahim Rahimian, has requested his death certificate and the number of his gravesite. As she has presented all the necessary documents and receipt number 33720 in the sum of 9000 rial, you are accordingly instructed to issue the necessary orders as indicated in the enclosed documents.


Mortuary Office


28 Farvardin 1363 [17 April 1984]

Signature or fingerprint of the applicant



[Handwritten note on top of the page]