[PROVISIONAL TRANSLATION FROM PERSIAN]

[Translator’s notes appear in square brackets]

[Personal information has been redacted.]

Decision of the Personnel Department

In the Name of God

Islamic Republic of Iran

Form A - 32(52-4) State Administrative and Employment Affairs Organisation

1- Ministry/Organisation: Education

2- Employee Number: [redacted]

3- Name: Mrs. Aghdasol-Molouk

4- Surname: Jananpour

5- Father’s name: Yaghoub

6- Identification number and place of issue - Identification number [redacted], place of issue: County Kermanshah, Province/Governorship of Kermanshah

7- Place of Birth: Kermanshah

8- Date of Birth: Day 8, Month 8, Year 1311 (8/8/1311) [30 October 1952]

Highest qualification: Diploma in the field of Technical Studies

10- Title of Organisational Position: Nursery School Teacher

11- Educational Field in the Field of Teaching, classification -----

12- Group 8

13- Base 12

Organisational Unit: Bahareno School

15- Place of service: Sector 14 City Tehran, Province/Governorship of Tehran

16- Licence as per the order

17- Type of order: Dismissal from service

18- Summary of the Order:

Based on the questionnaire form A, you have identified yourself as a member of the Baha’i sect. Therefore you are not covered by the State Employment [Act], and effective [date:] 1/6/1359 [3 August 1980] your employment is terminated and you no longer hold a position in the Ministry of Education. F

19- Salaries, benefits and allowances

20- Total of salary, benefits, and additional bonuses in this order: ----- rial, following the statutory deductions from the [remuneration] ----- Chapter ----- Paragraph ----- is payable.

21- Verdict enforcement date: 1/6/1359 [23 August 1980]

22- Date of issue and the order number: Date 12/6/1359 [3 September 1980] Number 17533/14

23- Name and surname of the responsible authority:  Asghar Naw Rouzi

Title of the organisational position: Director of the Department of Education - Sector 14

[Signature]

13/6/1359 [4 September 1980]

Copy: Employee