[Translator’s notes appear in square brackets]

[Personal information has been redacted.]



[Illegible] Iran

Decision of the Personnel Department


(In the Name of God)

Form A-(52-4) 32 - National Administration and Employment Organization


1- Ministry of Health and Welfare, Mazandaran Province

2- Staff Number: [redacted]

3- Name: Mr. Esfandiar

4- Surname: Forouzandeh

5- Father’s name: Ahmad

6- Identification Number and place of issue: Identification number: [redacted], Place of issue: City Babol County, Governor’s office of Mazandaran

7- Place of Birth: [redacted]

8- Date of Birth: Day 3; Month Ordibehesht; Year [redacted] [23 April [redacted]]

9- Highest qualification: Diploma; Field: Biology

10- Title of Organizational Position: Insect collector

11- Field: Health and Healing, Field: Healthcare, Classification: Four

12- Group: Five

13- Foundation: Ten

14- Organizational Unit: Management of Eradication of Malaria and Infectious Diseases

15- Place of Service: City Sari, Province Mazandaran

16- Licence: -----

17- Verdict type: Termination of Service

18- Order Summary:

As determined by our investigations, you are affiliated with the Baha’i sect and your employment has [therefore] been illegal as stipulated in Notification number 0428 -2 Bahman 1359 [22 January 1981] and copy of letter number 37317, [date] 23 Dey 1359 [13 January 1981] of the Regional Health Clinic Organization of Mazandaran Province and as set out in Circular number 7060- [date] 10 Dey 1359 [31 December 1980] of the honorable [illegible] Health Clinic, documents related to sections 14 and 16 of the Employment Act [illegible] and Social Welfare.  Your employment contract is hereby terminated ab initio and you no longer hold any position in this administration, effective 1 Bahman 1359 [21 January 1981]. This verdict can be appealed by completing the questionnaire, should you deny your alleged affiliation with the above-mentioned sect.

19- Salaries, benefits and perquisites

20- Salary, benefits and other supplementary income or allowances [outlined] in this order constitute the sum of ----- rial, after the usual deductions payable in relation to seasonal [allowances] ----- materials -----

21- Date of enforcement of the verdict: 10 Bahman 1359 [30 January 1981]

22- Date of issue and verdict number: Date 10 Esfand 1359 [1 March 1981], Number: 6101

23- Name and Surname of the responsible authority: Dr. Seyyed Jalal Osia

Organizational position: Manager of Agency for the Eradication of Malaria and Communicable Diseases, Mazandaran Province

Signature: [Signature]