Lao People's Democratic Republic

Peace Independ ence D emocracy Unity Prosperity

Vientiane Capital
Saysettha District No.91lNK-N
Nonkhor-Neua Village Date:26/0L1202L
Engagement Record
- Pursuantto Article 6 section L of family law No.05/NA, dated: 26luly 2008
- Pursuant to Decree of Prime Mister regarding to marriage between Laotian and Foreigner No.
198/PM, dated: 19 December 7994.
On the 04112/2020,atthe house of Mrs. Si, Unit 28, Nonkhor-Nuea Village, Saysettha District,
Vientiane Capital, there had been couple's engagement ceremony between Laotian and Foreigner for
marriage according to traditional between:
i Laotian side.
- Ms. Chanthala PHOMMALAYSI, date of birth: 14.06.1993, nationality: Lao, race: Lao, religion:
Buddhist, Occupation: Employee, Work place: Lakeview Golf club, Passport No. PAO347 47 6
dated: 26.L1.20L9, issued by: MOFA,LAO PDR,ldentity Card No. 02-18A23275, dated:
22.05.20L8, issued by: Public Security of Saysettha District, Household Registry Book No. 299,
dated: ZZ.A5.Z0\8, issued by: Publlc Securlgr of Saysenha Districr, Currenraddress: house No.
41,8, Unit: 28, Nonkhor- Village, Saysettha District, Vientiane Capital, Lao PDR.
- Name and surname of Father:.........,,....(dead)......,Age: Occupation:..................!.!..,..r....,.,r.,,.,
Currentaddress:..........,.....ViI1age,.................District,..........,.....Province,Country....
- Name and surname of Mother:....Mrs. Si............Age: B0.....Years old, Occupation:Housewife.........,

Current address: Nonkhor- Village, Saysettha District, Vientiane Capital, Lao PDR.

- Mr. Andreas Per Thomas fOHANSSON, date of birth: 03.10.1983, nationality: Swedish, race:
Swedish, religion: Christian, Occupation: Train driver, Work place: Vy Train Sweden....r..r...r...i..,..,
Passport No.: 93476653r...r......., dated: 3.08.2017.,...r........., issued by :Sweden...............,.....,,

Identity Card No.: 19831003........, dated: 27.04.20L2..........., issued by :Sweden....,.,..,,..,.,.......

dated:
Household registry Book No.:.........,......,...!i....i,, issued by,.....,...,.

Current address house No.:............, Unit........, Village:... Karlskrona District, Blekinge Lan
Province, Sweden.
- Narne and surname of Father: Mr.Thonias |OHANSSON, Age: 66 years old, Occupation: Retried...,

Current address:...,.,,.,.......Vilhge,..,.......,,...., Karlskrona District Blekinge Lan Province, Sweden.

- Name and surname of Mother: Mrs. Marianne Andersson, Age: 59 Years old, Occupation:

Pharmacist, Current address house No,:.,,..,,....,, Unit........, Village: Karlskrona District,

Blekinge Lan Province, Sweden.
There were the participations of parents, elders and relatives in engagement ceremony as
follorvlng names:

1,. Mrs. Viengsavah PHOMPHAKDI, Age: 52 Years old, Occupation: Housewife, Current address:
Amon Village, Saysettha District, Vientiane Capital, relationship: adoptive mother.
2. Name:....... , Age:........ Occupation:......................., Current address:
........,Village, ..................District, Province, relationship:............. .!!!i..!...,

3. Name: Age:
......., , Occupation:.....,..,..,,.,..,.,.,., Current address:
.........Village, ................,.District, Province, relationship'........,....

1,. Mrs. Si...... Ager 80 Years old, Occupation: Flousewife, Current address:
Nonkhor-Nuea Village, Saysettha District, Vientiane Capital, relationship: Mother....r...........,
2. Mr. Thongpane HASOUK......,., Age: 50 Years old, Occupation: chauffeur, Current address:
Nonkhor-Nuea Village, Saysettha District, Vientiane Capital, relationship: Uncle
3. Mr. Bounmy......................, Age: 52 Years old, Occupation:Trader, Current address:
Sokyai Village, Saysenha District, Vientiane Capiral, relationship: Uncle .:r..........,

According to the discussion of both parties unanimously had agreed with the
following:
1. The engagement dowry is deposited without evading from marriage ceremony such
as:

Dowries 20.000.000 L4K...........

f,ra&at
2. Other commitments of Tradition and Laws of the both parties:
rc,

FlUun0
)!un0u
b'l
Irfl[aufl
AI''DIM}ISI.AI
:fiUlCES
,/^.
w21_)
 3. Document Procession: Both Parties must perform the marriage approval accordance
with the Laws and Regulations.
+. If any parties infringe on this engagement certificate, that parties must be responsible
to family law regarding to fined due not implementing following engagement.
This engagement certificate has been recognized through witnesses of both parties
and had been agreed accordance to discussion of both sides, therefore, two sides
together signed as the documentary evidence.

Attached Attached

photo photo

Male's Signature Female's Signature

(Signed) (Signed)

Sisnatures of witnesses from male's sides Sisnatures of witnesses from Female's sides

L. (Signed) L. (Signed) Mrs. SI

2. 2. (Signed) Thongpane

3. 3. (Signed)

Certified by Village Chief where engagement Recorder Sisnature

(Signed and Stamped) 7. {Signed) Mrs. Khonpaseuth

Khamfong VONGPHACHANH 2.................

'qaruvno 70zt

,&cljqnflu
rrsl,ucqlmu
I/ISAANDTftINI

. SERVICES

Souphaks one PHOUN{AVONG

* Translated by SnP Visa and Translation Services
Tel: 020 55093189, E-mail: snpvisa@yahoo.com
D