[PROVISIONAL TRANSLATION FROM PERSIAN]

 

[Translator’s notes appear in square brackets]

[Personal information has been redacted.]

 

Government of the Islamic Republic of Iran

Form A-32 – (52-4) Department of State for Administration and Employment Affairs

 

  1. Ministry/Institute:  Ministry of Education
  2. Employee Number [redacted]
  3. Name: Mrs. Farideh
  4. Surname: Vojdani
  5. Father’s Name: Mashiatollah
  6. Birth Certificate Number and Place of Issue:

Birth Certificate Number [redacted] Place of Issue: County: [redacted] Province/ Governorate: [redacted]

7.  Place of Birth [redacted]

8.   Date of Birth:

Day: 27; Month: Aban; Year: [redacted]

9.   Highest Degree and Field of Study:

             Highest Degree: Diploma in Natural Sciences

10. Title of Organizational Determined Position: Teacher

11. Field: Educational and Cultural Field: Teacher: Grade: 3

12. Group: 4

13. Rank: 3

14. Organizational Unit: School [redacted]

15. Place of Employment:

County [redacted] Province/Governorate: Bushehr

16. Permission: Date: ___  Number: ___

17. Type of Order: Dismissal from Service [Employment]

18. Description of the order

Considering that she does not follow and believe in any of the recognized religions of the country, according to this order and circular number 52 dated 17 Tir 1360 [8 July 1981] of the respective Ministry, and based on section 14 of the Public Services Employment Act, [she is] dismissed from service in the Ministry of Education. A

       19.  Salary, Benefits, and Other Benefits:

Salary, Benefits, and Other Benefits: In this order a total in the amount of ______(in words) rial, after applying legal deduction and liabilities:___ chapter___ article:___  is payable.

21. Date of Enforcement of the Order: 1 Mordad 1360 [23 July 1981]

22. Date of issue and number of the order: 27 Tir 1360 [18 July 1981] number: 16096/2

23. Name and Surname of the Responsible Official: Abbasi

Title of the Organization’s Determined Position: General Director of the Education Department of Bushehr Province

     [Signature]

 

     Copy: The Employee