Translated from Russian into English
/The coat of arms of the Russian Federation/
Reissued
Birth Certificate
Ivanov
surname
Ivan Ivanovich
name, patronymic
was born on April 1, 2012
month, day, year (in figures and in words)
April the first,
year two thousand twelve
place of birth: Saint Petersburg, Russia
in witness whereof a birth record under № 1111 was made on the 1st (day) of May (month), 2012 (year).
Father: Ivanov
surname
Ivan Petrovich
name, patronymic
Russian Federation
citizenship
Russian
ethnicity (entered at father’s request)
Mother: Ivanova
surname
Olga Ivanovna
name, patronymic
Russian Federation
citizenship
Russian
ethnicity (entered at mother’s request)
Registration office: Civil Registry Office, Tsentralny District, Civil Registry Directorate of Saint Petersburg
name and location of Civil Registry Office
Date of issue: May 10, 2012
Head of the Civil Registry Office /signed/ M.V.Leonova
Seal here
/The seal of the Civil Registry Office affixed/
V- ЮЮ №11111
_______________________________ End of the translated document_ _______________________
