Prekladatel: Mgr.

Tom55 Kol6r - Juin6 trieda 28, O4O 01, Koiice

P re kladatel' jazyka : anglick6ho

Zad6vate[: PORTER, s.r.o., Plyndrenskd 3D 821 09 Bratislava - mestskd dast Ruiinov, Slovenskd
republika

Prekladatelskli rikon zo slovensk6ho jazyka do anglick6ho jazyka dislo: 503/2023

Predmet prekladu: eestn6 prehlSsenie

Podet strSn prekladanej listiny/podet strdn prekladu: 4/4

Podet odovzdan'ich vyhotoveni: 1

Translator: Mgr. Tom55 KolSr - Juini trieda 28, O4O 01, Koiice

Translator of: English language

Principal:P()RTER′ s.r.o.′ Plyn6rensk6 3D1 821 09 Bratislava― city district Ruttinov′ Slovak Republic

Translation from Slovak language into English language No.: 503/2023

Su bject of translation: Affidavit

i"l u m be r of pages of translated document / Number of pages of translatio n: 4/ 4

)'lumber of delivered copies: 1

 Tituln6 strana prekladu

Prekladatel'. Mgr. OxanaVizdalov6

争
T
zadavatel'i ProEdu, s.r.o., Plyn6renski 3D,
821 09 Bratislava

Cislo spisu(objednavky):BOJ232100014

PREKLAD cislo 66123

z jazyka ukrajinsk6ho do jazyka slovensk6ho

Predmet prekladu: eestn6 vyhl5senie

Pocet str6n prekladanej listiny: 1

(L Pocet str6n prekladu: 1

Pocet odovzdanlich vyhotoveni: 1

Bratislava, 09. 02. 2023

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statny znak ukrajlny

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PRiSLUSNYM KOMPETENTNYM ORGANOM,TYM

KOHO SA TO TYKA PODEA PRiSLUSNOSTl
od SERHIJA iVANOVYCA SMAHU彙 ,registraё n6 ёislo
evidenё nel kany platitela dani pOdl'a ttdaiOV StatnehO
regiStra fyZiCk,Ch OSOb― platitel'OV dani ёiS10
3029418492,(obё iansky preukaz sё ria NS ёislo
803945 vydany 28.04.2000 Cyhyrynskψ rn okresnyrn
oddelenirYl Spravy Ministerstva vntttra Ukrajiny
v Cerkaskom kr司 ￨),bytom na adrese:u‖ ca Myru 43,
obec Raceve,Cyhyrynskソ okres,Cerkaskフ kraj

CESTNE VYHLASEN:E
Ja, Serhij lvanovyi Smaha*, nem6m n6mietky proti tomu, aby som bol
zbavenli rodidovskfch prdv k mojej dc6re: Anne Serhijivne Smaha, narodenej
_中 21. augusta 2006, v obci Raceve, eyhyrynskli okres, eerkaskyi kraj
v srivislosti s tfm, Ze neposkytujem materi6lnu pomoc a nez0dastftujem sa
ufchovy diefafa.
* Pozn6mka prekladatel'a: prepis mena a priezviska v anglickom jazyku SERGIY
SMAGA uvedeni v cestovnom pase je totoini s tymto prepisom do slovendiny
podl'a z6kona o St6tnom jazyku

Ziadam, aby s0dne pojedndvanie v civilnej veci o zbavenf rodidovskfch

pr6v sa uskutodnilo v mojej nepritomnosti.
Tridsiateho j0la dvetisicdvadsat'
PODPIS: neiitatelny podpis Serhij lvanovyd Smaha
Mesto eyhyryn, eerkaskf kraj, Ukrajina.
Tridsiateho j0la dvetisicdvadsaf.
Ja, N. V. KOSTENKO, s0kromnf not6r eyhyrynsk6ho okresn6ho notdrskeho
obvodu osveddujem podpis Serhija lvanovyda Smahu, ktorf sa podpfsal v mojej
prltomnosti.
￨ Toto2nost Serhija lvanovyda Smahu, ktoni podpisal dokument, bola zistenS,
jeho sp6sobilost' preveren6.
Zaregistrovan6 v registri pod dislom 900.
Uhradenii poplatok podl'a $ 31 z6kona Ukrajiny O not6rstve
S0kromnif notdr: neditatefny podpis
Odttaiok okrilhlej peiiatky so Stdtnym znakom (text peiiatky: eyhyrynsky okresny
notdrsky obvod Cerkaskdho kraja * S1kromny notdr Nina Volodymyrivna Kostenko)
vRT 751902

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Koniec prekladu

strana 1 z 1

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Preklad som vypracovala ako prekradatelka zapisanl v zozname
znalcov, tlmodnikov a prekladatel'ov, ktoryi vedie lVlinisterstvo spravodlivosti
Slovenskej republiky v odbore slovenskf, ukrajinskf a ruskii jazyk, evidendn6
cislo 970385.
Preklad je v denniku zapisani pod distom 6a/Z Z
Preklad srihlasi s prekladanou listinou.
vyhlasujem,2e som si vedomd ndsledkov vedome nepravdiveho prekladu.

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 Title page of the translation

. i'anslator: Mgr. Oxana Vizdalovd

Client: ProEdu, s.r.o., Plyndrensk6 3D,

821 09 Bratislava

File (order) number: 8OJ232100014

TRANSLATION number 66123

from the Ukrainian language to the Slovak language

Subject of translation: Affidavit

Number of pages of translated document: I

Number of translation pages: 1

酬り■／Ｊ日

Number of copies submitted: I

﹁ヨ
Ｆ ＦＬ

Bratislava, February 9, 2023

 \ational emblem of Ukraine

UKRAINE

IO THE COMPETE\T 1.T THORITIES WHICH ARE CONCERNED ACCORDING TO

JURISDICTION from SERHIJ I\-\\OVYC Snf*fU*, registration number of the tax payer's
registration card accordr:r_: . ..r- t.:t.r :i the State Register of Natural Persons - Tax Payers number
r029418492, (lD card se:... .:r.r.r 803945 issued on April 28, 2000 by the Chyhyryn district
Jeparlment of the .A.dr: : . , -
"' ' :i:e \'linistry of Internal Affairs
of Ukraine in the Cherkasy
region), residing in: \1'.:- .-'-,' -: r..,..'\e rillage, Chyhyryn district, Cherkasy Oblast

AFFIDAVIT

,'." -
I. Serhiy Ivanovri S: r -;i tr being deprived of parental rights to my daughter: Anna
.\erhijivne Smalto.:-*' : - I 16. in the village of Raceve, Chyhyryn district, Cherkasy
Oblast in connecti,:': . r,-r not provide material assistance and I do not take parl in
raising the child.

til * Translator's nfre: the rf,E$sTti.,n of the name and surname in English SERGIY SMAGA
mentioned in th nassprt !g isrrrr.; t.'r this transcription into Slovak according to the State Language
Act

I requestthat tl-.; : .- - " : ::1er regarding the deprivation of parental rights be held in
my absence.

July thirrieth. .,.

S IGNATURE: rilryc'*r'rs flunmv:l Serhiy Ivanovyd Smaha

City of Ch.vhlrlu CUcatuf &cs+;m" - {,*:. -;

July thirtieth- tu,r hnnmt m& r,$,sfi"nr-

tf I, N. \-. :r ':e tJhtryr}'n district notary district, certify the signature of

Serhi、 1ヽ こ:I _ n[]|l'., l-3ience.

The idcntir. - :: ,le document, has been found out, his eligibiliS,
has been \;r : -

Enlisted i■

Paid fee 、:ll Iヽ

Private nota['

Imprint o.l ,i ' . )tdnlp; Chyhyrynslq, District llotary

District of . it nny' iyna Ko,sten ko)
 VRT 751902

WARIヾ ING!The forin contains nlulti‐ level anti‐ forgcry protection.

MINISTRY OF JUSTICE OF UKRAINE

丼*十 *,■ ■贅*丼 *黎 夫 ,■ ,,X,****X,X,X*,*******X*X**黎 *黎 丼丼*****よ *
*夫 よ贅贅,,■ ,*業 黎X,*,,****X*黎 *,黎 黎X,X,*■ ,■ ■,■ ,■ *

End of translation

びり
￨￨

￨￨￨

●
 TRANSLATOR'S STATEMENT
I have translated the document attached hereto as a certified translator registered
in the List of Experts, Interpreters and Translators kept by the Ministry
oiJustice
of the slovak Republic, Slovak, ukrainian and Russian i*grrug.
Section, under
registration number 97 0385.
The translation is entered in the translator's book under number
66123.
The translation corresponds to the content of the translated
document.
I hereby declare that I am aware of the consequences arising from the
knowingly
false translation.

Round stamp:

Mgr. Oxana yizdalov|

Translator

Language S lovak-Ukrainian-Russian

Translator's signafure:

Illegible signature
 PREKLADATEESKA DOLOZKA
Preklad/preHadatcrskt tkon som vypr“ 。val ako prekladatcl,zapisanl夕 v zozname znalcov,
tlmOё n■ OV a preHdatCrOV,korl夕 vcdie MinisterstvO spwOdlivosti S10vcnsktt republiky,v
OdbOre prejaZyk angliCktt pOd eVidenё n′ m Mslom 971381・
ハ
Prckla″ pКHadateFsk′ ikOnje zapls狙 ′v dennfku pOd Mslom′ ζP/7.9ζ 多
͡_ _ム
Prekl配 範distiny sinasia s prel。 2en′mi listinami。
Z奮OVei VyЫ 器 可 em, 労e som si vedOm′
nasledkov vedomc neprⅣ divё h。
prekladゴ preЦ dateFskё h0 1lkOnu.

TRANSLATOR'S STATEM[ENT
hereby cenlf、「that I har e translated the dOculment attached hereto as a ce■ i■ ed translator
,gistered ln the List of Esperts, Interpreters aind Translators kept
by the Ministry 0 f J ustice of
S lovak Republic. English Language Section, under registration nurn ber 97 1381.
translation translation act lS entered ln the translator' S book under number .Jη多 /2ρ 3
translation corresponds to thc content of the translated document.
hereby declare thar I am aware of the consequences arising from the knowingly false
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