[Translator’s notes appear in square brackets]

[Personal information has been redacted.]


In the Name of God, the Exalted

Government of the Islamic Republic of Iran

Order of Pension or Disability Settlement

Form: 44 Ayn (54/3), Administrative and Recruitment Affairs Organization of Iran


1- Ministry/ Institution: Agriculture and Rural Development Cooperative

2- Employee number: [redacted]

3- Date and number of order of Pension or Disability 

Date: 10 Aban 1359 [1 November 1980] Number: [redacted]

4- Name Mr.: Bahram

5- Surname: Nabi-Elahi

6- Father's name: Ali-Geda

7- Date of birth: [redacted]

8- Birth certificate number: [redacted]

9- Place of issue of birth certificate: [redacted]

10- Gender: Male

11- Employee status: Retired

12- Date of retirement or disability: Day 1 Month Bahman Year 1359 [21January 1981]

13- Title of last job or permanent organizational position: In charge of Rural Development and Restructuring of Mazandaran, Cooperative Head office

14- Group / rank: 6

15- Grade: 12

16- Employee status: Subject to State Employment Act, ratified 31 Khordad 1345 [21 June 1966] Article: 137

17- Legal endorsement of establishment of pension or disability benefits: Based on addendum of Article 74 of State Employment Act and in accordance with addendum F / 85

18- Pension or disability benefits: 38,900 rial

19- Deduction of pension debts:

Type of debt - deduction of unofficial service and military

Amount of debt (in rial) 60,365

First instalment (in rial) 893

Monthly instalments (in rial) 826

Number of instalments 73

Amortization date: 1 Esfand 1365 [20 February 1987]

20- Pension or disability benefits are payable from the petty cash in part payment after statutory deductions as per series 19 pending approval of State Pension Bureau

21- Enforcement date: 1 Bahman 1359 [21 January 1981]

22- Date of issuance and number: 18 Bahman 1359 [7 February 1981] number: 49762

23- Name and surname of the officer in charge: Gholam-Reza Pour Ebrahimi

Title of permanent organizational position: Supervisor of Personnel and Organization

Copy: Employee