TRANSLATION

PEOPLE’S COMMITTEE SOCIALIST REPUBLIC OF VIETNAM Form TP/HT 2

Ward, Commune: Chuong Duong Independence – Freedom - Happiness No.: 24
District: Hoan Kiem Book No.: 01/95
Province, City: Hanoi

BIRTH CERTIFICATE
Full name: NGHIEM THU HUONG Gender: Female
Date of birth: 12.01.1995 (January 12th, 1995)
Place of birth: National Hospital of Obstetrics and Gynecology
Ethnic group: Kinh Nationality: Vietnamese
PARENTS’ DETAILS Mother Father
Name in Full PHAM Kim Hai NGHIEM Minh Thuyet
Age 1961 1958
Ethnic group Kinh
Nationality Vietnamese
Occupation Cadres Cadres
Place of residence No. 17, Hop Luc Alley, Chuong Duong Ward, Hanoi

Full name, Age, Identification Card No. of Informant: Father

Informant Registration on February 14th, 1995

(signed) ON BEHALF OF PEOPLE’S COMMITTEE
NGHIEM Minh Thuyet Vice Chairman
(signed and sealed)
NGUYEN Son Ha