[Translator’s notes appear in square brackets]

[Personal information has been redacted.]


In the Name of God

Government of the Islamic Republic of Iran


Decision of the Office of Personnel

Form: (52 – 4)32-A Department of State for Administrative Affairs and Employment


  1. Iranian Tobacco Company
  2. Employee number: [redacted]
  3. Given Name: Mrs. Shahla
  4. Surname: Razi
  5. Name of father: Lotfollah
  6. Birth certificate number and place of issuance
  • Birth certificate number: [redacted]
  • Issued in: [redacted]
  1. Place of birth: [redacted]
  2. Date of birth: 11 Tir [redacted] [2 July]
  3. Highest degree and field of study
  • Highest degree: Sixth grade
  1. Title of Permanent Government Position:  Typist, Position number  2544
  2. Classification: Administrative and Financial:  Branch: ----- , Grade: ------
  3. [Employment] Category:  5
  4. [Employment] Level:  9
  5. Government unit: Tobacco [Company], Urmia Region
  6. Place of employment: City of Urmia, Western Azerbaijan Province
  7. Permit: Single-Article Date: ----, Number: ----
  8. Category of Decision: Termination of Employment
  9. Details of Decision:

According to letter number 3572/M – 14 Mehr 1360 [6 October 1981] of the Office of the Provincial Governor General of Western Azerbaijan, and with the company’s concurrence, based on this decision, your employment will be terminated from the date of your absence from administrative services at the Tobacco [Company] of Urmia Region, and you will not have any rights or position after that date.

  1. Salary, benefits and bonuses ………..
  2. Salary, benefits and bonuses specified in this ruling amounting to a total of (spelled out) ……….. are payable after applying legal deductions from Credit ----, Articles -----
  3. Date of the ruling’s execution: As described in item 18.
  4. Date of issuance and ruling number

Date: 1 Dey 1360 [22 December 1981], Number: 91105

  1. Given name and surname of the official in charge: -----

Title of permanent organizational position [of the official in charge]: On behalf of the General Manager and the head of the Board of Directors

Signature [signature]

Copy: Employee