[PROVISIONAL TRANSLATION FROM PERSIAN]

 

[Translator’s notes appear in square brackets]

[Personal information has been redacted.]

 

[Emblem]

Islamic Republic of Iran

Personnel Order

Form A-32 (52:4) Department of State for Administrative Affairs and Employment

 

1-Ministry/Institution: Health and Welfare

2-Employee Number: [redacted]

3-Name: Mrs. Parvin

4-Surname: Vafaie

5-Father’s Name: Mirza-Agha

6-Birth Certificate Number and Place of Issue: [redacted], Place of Issue: [redacted], Province: Khorasan

7-Place of Birth: [redacted]

8-Date of Birth: 1 Shahrivar [redacted] [23 August]

9- Education and highest qualification: PhD in Medicine

10- Position: General Practitioner 4246-B

11-Category: Health and Therapeutic, Field: Doctor, Level: 2

12-Group: 9

13- Rank: 4

14-Orgaisational Unit: Dr. Fatemi Hospital

15- Place of Employment: Mashhad, Province: Khorasan

16-Permit: Date -----Number -----

17-Type of verdict: Termination of Service

18-Verdict Statement:

Enforcing instruction number 7560, dated 10 Dey 1359 [31 December 1980], of the Health Ministry, and considering that as per questionnaire number 12M, dated 28 Dey 1359 [18 January 1981], you associate yourself with the perverse Baha’i sect, and persist in your belief, therefore, in accordance with Article 14 of the Employment Act and Article 6 of the by-laws of the Social Security Act and other employment regulations, where lack of corrupt conviction is one of the employment conditions, your initial employment is in conflict with all relevant regulations, therefore, in accordance with this ruling, all your previous employment orders are cancelled, and from the date of this ruling your services are terminated.  For the years of service in the past, you will be treated in accordance with the Employment Act.

19-Salary and others:

A- Base Salary: ----- rial

B- Salary difference adjustment ----- rial

C- Total of ongoing benefits and one off benefits, bonuses. ----- rial

D- Difference in bonuses adjustment. ----- rial

E- Bonus for working abroad. ----- rial

F- Bonus for inclement weather. -----rial

G- Bonus for deprivation of life privileges. -----rial

H- Extras for place of employment. -----rial

I- Other benefits. -----rial

Total ----- rial

20- The total amount of the salary, benefits and allowances mentioned in this order ----- rial, after legal deduction is payable.

21- Verdict enforcement Date: Verdict issue date

22- Issue date and Verdict number: Date: [illegible] 1359 [1981], Number 8/82451

23- Name and surname of the person in charge: On behalf of Dr. Jafarzadeh

[Signature]

Organizational Position: General Manager of Regional Health and Welfare Organization of Khorasan

Copy: -----