[Translator’s notes appear in square brackets]

[Personal information has been redacted.]



Islamic Republic of Iran

Form A - 57 [illegible]

1 - Ministry /Institution of Roads and Transportation - The State Aviation Organization

2 - Employee number [redacted]

3 - Name: Mrs. Shokouh

4 - Family Name: Nazar

5 - Father's Name: Nourollah

6 - Birth Certificate Number and Place of Issue: Birth Certificate Number: [redacted] Place of Issue: City Tehran Province/ General Governorship Markazi

7 - Place of Birth: Tehran

8 - Date of Birth: 8/1/1329 [28 March 1950]

9 - Highest Degree and Field of Education: highest degree: Dipoma Field: Natural [sciences]

10 - Title of Organizational Permanent Position: In charge of public affairs and media number series 1/11

11 - Class: Social Affairs Field: In charge of public relations and parliamentary affairs Category: two

12 - Group: Four

13 - Rank: Three

14 - Organizational Unit: Department of Information and Public Affairs

15 - Place of Service: City Tehran - Province /General Governorship Markazi

16 – License:

17 - Type of Order: Permanent Discharge from Government Service

18 - Description of the Order: In accordance with this Order, which is pursuant to the provisions of the Constitution and article C, section 14, of the State Employment Act, and which takes into consideration decision number 8, dated 59/6/4 [1980/08/26], of this organization's Cleansing and Purification Commission, since, based on available documents, you belong to the perverse Baha’i sect, you are discharged from employment in all government organizations, effective on the date, registered in section 21 of this Order. H/

19 - Salary, benefits and bonuses

20 - Total of salaries, benefits, allowances and bonuses mentioned in this Order, in letters ---- rial

Following the statutory deductions from the credit ----- Chapter ----- Paragraph ----- is payable

21 - Date of execution of Order: 1/11/1359 [21/01/1981]

2 - Date of Issue and number of the order - Date: 10/12/1359 [02/01/1981] Number: 15009

23 - Name and surname of the responsible person: Kazem Samadian [signature]

Title of permanent organizational position: Deputy Minister of Roads and Transportation and Director of State Aviation Organization

Copy: Employee