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CONSULA T GENE RAL

DE LA REPUBLIQUE DU CAMEROUN
A PARIS - FRANCE

CONSULA TE GEN ERAL


OF THE REPUBLIC OF CAMEROON
IN PARIS - FRANCE

N ____

/CGCP/SEC/

Paris, le

CENTRE D'ETAT-CIVIL
CIVIL STATUS REGISTRATION CENTER
DE OF

COPIE D'ACTE DE DECES


Copy of death certificate
Nom du &cede
Name of deceased

Le on the ___________________________________________________________________________________________
Est decede a Died at ________________________________________________________________________________
Age (e) de Aged _____________________________________________________________________________________
Ne (e) le Born on the ___________________________ a at ________________________________________________
Prefession Occupation _______________________________________________________________________________
Domicilie a resident at _______________________________________________________________________________
Fils ou fille de Son or daughter of _______________________________________________________________________
Demeu rant a resident at _____________________________________________________________________________

Et de and of
Demeu rant a resident at _____________________________________________________________________________
Dresse le Drawn up on the _____________________________________________________________________________
Sur la declaration de
In accordance with the declaration of

Lesquels ont certifie la sincerite de la presente declaration


Who attested the truth of this declaration

Par nous By us _____________________________________________________________________________________

Le declarant

Signature de l'Officier de l'Etat-civil

The Declarant

Signature of Registrar

Adresse : 73 rue d'Auteuil - 75016 Paris / Tel. : 01 46 51 89 00 - Fax : 01 40 71 54 32

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