[Translator’s notes appear in square brackets]

[Personal information has been redacted.]


10 Farvardin 1392 [30 March 2013]


In the Name of God

I am Zein-Ali Verdipour a resident of the Village of Ali Kola, and I hereby declare that on 26 Mehr 1391 [17 October 2012], I used my tractor to plant autumn barley at the request of Mr. Ghavamoddin Sabetian, Ali Piri and Seyyed Mohammad Derakhshan and… on their agricultural lands, located in Estelsar Ivel. But I was harassed and prevented by two residents from Ivel, named Nad-Ali Fallahpour and Seyyed Javad Derakhshan, and I had to stop the cultivation work.


Zein-Ali Verdipour [Signature]


[Signature on official stamp]

Photocopy is identical to the original


[Postal stamp with stamp of “Cancelled” on it]