[PROVISIONAL TRANSLATION FROM PERSIAN]

 

[Translator’s notes appear in square brackets]

[Personal information has been redacted.]

 

[Emblem]

Islamic Republic of Iran

Ministry of the Interior

The Personal Status Registration Office

Death certificate extract

 

On 6/10/1360 [27 December 1981]; residence number....City of Tehran; ...village... Tehran county; Mrs. Jinous surname: Nemat [illegible]; daughter of Abbas and Kamlieh; born in 1308 [1929]; identification number [redacted]; issued in Tehran; part of area 4 of the Personal Status Registration Office of Tehran, has died of illness/accident and her death was registered in the Deceased Register, year 1360 [1981] in Tehran at the Registry of Behesht e Zahra, number 15106, on 15/10/1360 [5 January 1982].

This intact and unmarred copy was delivered to Mr. Joubin Nemat Kia, son of…

Place of signature of the representative and seal of Tehran District

The Personal Status Registration Office: Behesht e Zahra

15/10/1360 [5 January 1982]

[Signature over official stamp]