TRANSLATION OF FOREIGN BIRTH CERTIFICATE

ISSUING NATION

ISSUING STATE

ISSUING CITY / MUNICIPALITY

DATE OF REGISTRATION

CERTIFICATE NUMBER

ID / REGISTRATION CODE

= = = = = = = REGISTERED CHILD = = = = = = =

FIRST NAME

MIDDLE NAME

SURNAME (S)

DATE OF BIRTH

PLACE OF BIRTH

SEX

= = = = = = = CHILDS PARENTS = = = = = = =

FATHER:

FIRST NAME

MIDDLE NAME

SURNAME (S)

MOTHER:

FIRST NAME

MIDDLE NAME

SURNAME (S)

= = = = = = = CIVIL REGISTRY OFFICIAL = = = = = = =

TITLE

FIRST NAME

SURNAME(S)

CERTIFICATION OF TRANSLATOR
I, TRANSLATORS NAME, declare under penalty of perjury that I understand the Spanish language and the English language; and that, to the best of my knowledge and belief, the statements in the English language in the attached translation have the same meaning as the statements in the Spanish language in the document that I have examined. Signature of Translator ________________ Date