[PROVISIONAL TRANSLATION FROM PERSIAN]

 

[Translator’s notes appear in square brackets]

[Personal information has been redacted.]

 

Correction Order or Added Pension or Dismissal

Form A (36-1) 57 - Ministry of Administration and Employment

 

1- Ministry/Establishment: The Institution for the Development of Agricultural Machinery

2- Employee number: [redacted]

3- Retirement number: [redacted]

4- Details of employee:

Name: Mrs. Zia

Surname: Vojdani

Father’s name: Ghorban-Ali

Date of Birth: Day 7, Month Bahman, Year [redacted] [27 January [redacted]]

Birth certificate number: [redacted]

Issued in Dasht Gorgan

District / Governor general -----

Gender: Male -----; Female –X--

5- Employment status:

Retired –X--

Unemployable due to work -----

Unemployable not because of work -----

6- Date of retirement: Day 1, Month Mehr, Year 1358 [23 September 1979]

7- Employment status of employee:

A= ----- State employment law approved on 1301

B= ----- State employment law approved on 31 Khordad 1345 (2525) [21 June 1966]

P= --X-- subject to other provisions (with mention of kinds of provisions) Public companies

8- Description of order:

According to verdict number 16913/15855/630 - 4 Mordad 1360 [26 July 1981], from the personnel department of the Ministry of Agriculture and Urban Development, and according to Paragraph Th of Article 14 of the National Employment Regulations (you are dismissed from your service).  Your pension will be discontinued as of 4 Mordad 1360 [26 July 1981].

[Signature]

9- Date and number of last verdict/order:

Date: 10 Mehr 1358 [2 October 1979], Number: 12202.

10- Amount of pension or disability payment established in the last order: 38,300 rial

11- Current amount of pension or disability payment: ----- rial

12- Increase ----- rial

13-Debt Pension contributions

Type of debt (rial) -----

Amount of debt (rial) -----

The first installment (rial) -----

Monthly installment (rial) -----

Number of installments -----

Depreciation date -----

14- Retirement payments are payable after the [illegible] country.

15- Date of execution of the order: Day 4, Month Mordad, Year 1360 [26 July 1981]

16- Issuing date and number: Date: 25 Mordad 1360 [16 August 1981], Number: 12868

17- Name and surname of the responsible authority:  Mahmoud Jamali

Title of organizational position: Director

Signature: [signature]

Copy: Employee