[Translator’s notes appear in square brackets]

[Personal information has been redacted.]




The Islamic Republic of Iran

Decision of the Office of Personnel

Form Ayn- 32(5204) Department of State for Administrative and Employment Affairs


1- Ministry/ Department of Agriculture and Rural Development

2- Employee number: [redacted]

3- Given Name: Mr Khosrow

4- Surname: Foruzan

5- Name of father: Ibrahim

6- Birth certificate number and place of issuance

  • Birth certificate number: [redacted]
  • Issued in: [redacted]
  • City: [redacted]
  • Province:  [redacted]

7- Place of birth: Babol

8- Date of birth: 26/6/1320 [17 September 1941]

9- Highest degree and field of study

  • Highest degree: Third grade middle school

10- Title of Permanent Government Position:  In charge of artificial insemination

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 employment: City of Ghaemshahr, Mazandaran Province

16-Permit: Date: 7/5/1360 [29 July 1981] Number: 16460/K

17- Category of Decision: Termination of Employment

18- Details of Decision:

Following directive number 630/17664/19378 dated 17/5/60 [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: 17/5/1360[8 August 1981]

22- Date of issuance and ruling number
Date: 25/5/1360 [16 August 1981], Number: [Not readable]/630-[Stamp]21426

23- Given 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: [Not visible] [signature]

Copy: Employee