[PROVISIONAL TRANSLATION FROM PERSIAN]

[Translator’s notes appear in square brackets]

[Personal information has been redacted.]

In the Name of God

[Emblem]

Islamic Republic of Iran

Ministry of the Interior

Police Force of Iran

[Official stamp]

[Photograph]

Telephone -----

Number -----

Date -----

From: Identity Verification Office (fingerprints section)

To: Chief Justice of the Public Prosecutor’s Office, Tehran

Related to: Giti Zebarjadi, daughter of Abdol- Rasoul, identity number [redacted], Tehran, born 1318 [1929]

The above-named person has requested a police clearance and has the following criminal record. Please take the necessary action in this matter.

1 – Accusation: Espionage in favour of foreigners, writ of summons number 1/41893/2/62, [dated] 18/12/1362 [8 March 1984], the Public Prosecutor of the Central Islamic Republic.

2 – Accusation: Membership in Baha’i organisations and spying for Israel, writ of summons number 2/346662/630, [dated] 22/1/1363 [11 April 1984], the Public Prosecutor of the Central Islamic Republic.

Head of Identity Verification Office [illegible]

From: Colonel [illegible]

[Signature]

[Handwritten note, number and date at the top of the page]

14/8294

25/9/1364 [16 December 1985]