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ШАБЛОН ПЕРЕВОДА СОГЛАСИЯ НА ВЫЕЗД С РУССКОГО НА АНГЛИЙСКИЙ

Translated from Russian into English

/The coat of arms of the Federal Notarial Chamber/

78 A Б 0000000

Child Travel Consent

Saint Petersburg

The seventh of May year two thousand nineteen

We, citizen Ivanov Ivan Ivanovich , born on June 1, 1970, place of birth: Saint Petersburg, citizenship: Russian Federation, gender: male, the internal Russian passport 40 00 000000, issued by the police department №00 of Moskovsky District, Saint Petersburg, on April 1, 2000, subdivision code 777-777, registered at the following address: 10 Lenina street, apt. 1, Saint Petersburg

and citizen Petrova Olga Petrovna , born on June 1, 1970, place of birth: Leningrad, citizenship: Russian Federation, gender: female, the internal Russian passport 40 00 000001, issued by the police department №00 of Vyborgsky District, Saint Petersburg, on April 1, 2000, subdivision code 777-777, registered at the following address: 10 Lenina street, apt. 1, Saint Petersburg

hereby consent to independent and unaccompanied travels of our minor son, Ivanov Petr Ivanovich , born on June 1, 2005 , birth certificate I-A К №000000, issued by Malyutka Birth Registration Palace, Civil Registry Directorate of Saint Petersburg City Government on June 10, 2005, birth record №1111, birth record date: June 10, 2005, to the United Kingdom of Great Britain and Northern Ireland, Ireland, United States of America, the Republic of Bulgaria, as well as to any country of the Schengen area, as follows: the Republic of Austria, the Kingdom of Belgium, Hungary, Federal Republic of Germany, the Hellenic Republic, the Kingdom of Denmark, Iceland, the Kingdom of Spain, the Republic of Italy, the Republic of Latvia, the Republic of Lithuania, the Principality of Liechtenstein, the Grand Duchy of Luxembourg, the Republic of Malta, Netherlands, Kingdom of Norway, the Republic of Poland, the Republic of Portugal, the Slovak Republic, the Republic of Slovenia, the Republic of Finland, the Republic of France, the Czech Republic, the Swiss Confederation, the Kingdom of Sweden, the Republic of Estonia, and return to the Russian Federation during the period from June 1, 2019 (the first of June year two thousand nineteen) to March 18, 2023 (the eighteenth of March year two thousand twenty-three) .

There will be no adoption or changes in the aforementioned period of stay of Ivanov Petr Ivanovich outside the Russian Federation.

The content of the articles 20-23 of the Law of the Russian Federation “On the procedure for exit from the Russian Federation and entry into the Russian Federation” was explained to us by the notary and is clear.