CONG HOA XA HOI CHU NGHA VIET NAM

oc lap - T do - Hanh phuc

N XIN XAC NHAN TAM TRU

Knh gi : CONG AN PHNG 12, QUAN TAN BNH,
TPHCM.
Toi ten

: NGUYEN TH THUY VAN

Sinh nam :

1965
Thng tru

: 89 Trng Chinh, P.12, Q. Tan Bnh,TPHCM.

Toi lam n nay knh mong Cong an P. 12, Q. Tan Bnh xac
nhan cu the nh sau :
Cha toi la : NGUYEN MINH T Sinh nam : 1927
Ho chieu so : PT50278/91C1cap ngay 15/10/1991 do
Cuc Quan ly Xuat Nhap Canh nc CHXHCN Viet Nam cap.
T nam 1983 en nam 2009 c tru tai My cung con
chau. en thang 10/2009 ve Viet Nam va tai 89 Trng
Chinh, Phng 12, Q. Tan Bnh, a en ang ky tam tru tai
Cong an P.12, Q. Tan Bnh, TPHCM, ngay 15/7/2015 ong
Nguyen Minh T chet v benh gia tai nha so 89 Trng
Chinh, P.12, Q. Tan Bnh, TPHCM.
Nay toi lam n nay knh mong c quan cong an Phng
xac nhan cho ong Nguyen Minh T tam tru thi gian t
thang 10/2009 en ngay 14/07/2015 tai a ch tren e bo
tuc ho s lam giay bao t cho cha toi la ong Nguyen
Minh T.
Toi xin cam ket ve noi dung trnh bay tren ay la
ung s that va chu trach nhiem trc phap luat ve
cam oan cua mnh.

Xac nhan cua Cong an

Phng 12

Phng 12, ngay 17 thang 8

nam 2015
Ngi lam n

Quan Tan Bnh

Nguyen Th Thuy Van