[Translator’s notes appear in square brackets]

[Personal information has been redacted.]



Islamic Republic of Iran

Decision of Personnel Office

Form [52-4] 22 -A,   Department of State for Administrative Affairs and Employment


  1. Ministry/Institution:  Department of Education
  2. Employment Number:  [redacted]
  3. First Name:  Minadokht
  4. Last Name:  Forouzan
  5. Father’s Name:  Ebrahim
  6. Birth certificate number and place of issue:
  • Birth certificate number:  [redacted]
  • Place of Issue: [redacted]
  • City of [redacted]
  • Province:  [redacted]
  1. Place of Birth:  [redacted]
  2. Date of Birth: [redacted]
  3. Highest level of education and degree: High School Certificate in Sciences
  4. Title of Permanent Government Position:  Teacher
  5. Branch:  Education and Culture, Course: Teaching, Group: Fourth
  6. [Employment] Category:  5
  7. [Employment] Level:  6
  8. Government Unit:  Department of Education, Babol [Branch]
  9. Place of Service:  City of Babol, Mazandaran Province
  10. Permit:  Details in the Directive
  11. Category of Decision:  Dismissal from Employment
  12. Details of Decision:

With reference to letter number 50312/1, dated 25 Esfand 1359 [16 March 1981], from the Department of Education in Babol, since you are a follower of Baha’ism, and as the employment law, stipulates that the employment of those who do not believe in one of the country’s officially recognized religions is in violation of said law; your service with the Ministry of Education is accordingly terminated effective on the date of this decision. / /15B

19. Salary, benefits, and allowances:

20. Salary, benefits, and allowances included in this directive total an amount of (in words)________ rials, and are  payable after all legal deductions are made _____ chapter____ article____.

21. Decision implementation date:  [from the date of] Issuance

22. Date of Issue and Decision Number:  Date 16 Farvardin 1360 [5 April 1981], Number: [illegible]/615

23. Name of Officer in charge:  Director general- Khademian

Title of Permanent Governmental Position:

Signature:  [Signature]

Copied to:  The employee

[Handwritten note at the top of the page]