The citizen Ivanov Ivan Ivanovich was born on 9/IX-1975 (September 9, 1975).

Place of birth:
city, settlement Zaransk
district
region, land Zaransk region

Republic Russian Soviet Federative Socialist Republic
It is registered under the number 2345 in the Register of Birth on September 22, 1975.

PARENTS:
Father: Ivanov Boris Nikolaevich
Nationality Russian

Mother: Ivanova Valentina Petrovna
Nationality Russian

Place of registration Zaransk municipal civilian registry office.
Date of issue September 22, 1975.
Registrar of the Register Office (signature)
I-ИГ № 345678
Official seal

August 19, 2000

I, Golovotypkina J.D., a notary of the city of Muhosransk, certify the authenticity of this copy to the original document. In the latter there being neither deletions, nor additions, nor crossed-out words, nor any other unspecified corrections or any peculiarities.
Filed in the register under № 3210
Charged 0,84 r. Notary (signature)
License № 123456 given at 20.07.95
Official seal.

Translated from Russian by Karakumova A.B. Переведено с русского языка Каракумовой А.Б.
Переводчик ____________________

"____"____________2000г.
Я, Головотяпкина Ж.Д., нотариус г.Мухосранска, свидетельствую подлинность подписи переводчика Каракумовой А.Б., переводившей с русского языка на английский язык. Личность переводчика мне известна.
Зарегистрировано в реестре № ____________
Взыскано _____________
Нотариус ________________
Лицензия №123456 Выдана 20.07.95г.