[PROVISIONAL TRANSLATION FROM PERSIAN]
[Translator’s notes appear in square brackets]
[Personal information has been redacted.]
[Emblem]
Islamic Republic of Iran
Decision of the Office of Personnel
Form (52-4) 32-A Department of State for Administrative Affairs and Employment
1- Ministry/ Department of Agriculture and Rural Development
2- Employee number: [redacted]
3- Given Name: Mr Khosrow
4- Surname: Forouzan
5- Name of father: Ebrahim
6- Birth certificate number and place of issuance
- Birth certificate number: [redacted]
- Issued in: [redacted]
- City: [redacted]
- Province: [redacted]
7- Place of birth: [redacted]
8- Date of birth: Day: 26, Month: Shahrivar, Year: [redacted][17 September]
9- Highest degree and field of study
Highest degree: Third grade middle school
10- Title of Permanent Government Position: In charge of artificial insemination 463
11-Division:
- Agriculture, Responsibility: Assistant technician of animal husbandry
- Group: Two
12- [Employment] Category: 3
13- [Employment] Level: Seven
14- Government Unit: Agriculture Head Office – Mazandaran Province
15- Place of service:
- Town: Qaemshahr
- Province/Governorate: Mazandaran
16-Permit: Date: 7 Mordad 1360 [29 July 1981] Number: K/16460
17- Type of Ruling: Termination of Employment
18- Description of Ruling:
Following directive number 630/17664/19378 dated 17 Mordad 1360 [8 August 1981] and in accordance with that administrative order and Clause S of Article 14 of The Public Services Employment Act, you are hereby dismissed from employment. .
19- Salary, benefits and bonuses ………..
20- Salary, benefits and bonuses specified in this ruling amounting to a total of (spelled out) ……….. are payable after deductions ……….
21- Date of the ruling’s execution: 17 Mordad 1360[8 August 1981]
22- Date of issuance and ruling number
- Date: 25 Mordad 1360 [16 August 1981],
- Number: 18930/630-[stamp:] 21426
23- Name and surname of the official in charge:
Title of permanent organizational position [of the official in charge]: On behalf of the Minister of the Agriculture and Rural Development
Signature: [illegible]
Copy: Employee