Translated from Russian

MINISTRY OF INTERNAL AFFAIRS OF THE

RUSSIAN FEDERATION (MVD of Russia)
№ 0000 №0000000000
Main Directorate of the Ministry of the Interior
Affairs of Russia in Moscow
(GU MVD of Russia in Moscow)
Zonal information center
Moscow, Petrovka st., 38, 127994
tel.: 8(495)694-77-30, 8(495)694-77-40

00.00.0000 No. 000/000000-E

REFERENCE
on the presence (absence) of a criminal record and (or) the fact of criminal prosecution, or on the termination
prosecution

SURNAME NAME MIDDLENAME

(last name, first name, patronymic (if any) of the person being checked, including those previously available, in the nominative case)

00.00.0000, CITYOFBIRTH
(Date and place of birth)

FKU "GIAC MVD of Russia", ZIC GU MVD of Russia in Moscow, IC GU MVD of Russia for
(IC of the territorial body of the Ministry of Internal Affairs of Russia at the regional level)

Moscow region

there is (is not) information about the conviction in the territory of the Russian Federation:

not available
(date of conviction, name of the court that delivered the sentence, paragraph, part, article of the criminal law, information about the re-qualification of the act, term and type
punishment, date and grounds for release, grounds for removal of conviction)

there is (is not) information about the fact of criminal prosecution or about the termination of criminal prosecution on the
territory of the Russian Federation:

not available
(information on the implementation of criminal prosecution, name of the body that made the decision, paragraph, part, article of the criminal law, date

and grounds for termination of criminal prosecution)

Additional Information: not available

The original of the electronic document signed by the ES is stored in the subsystem "Electronic journal of
issued certificates" of the "IBD-M" service

Information about the EP certificate

To whom issued:
Serial No.: 0000000000000000000000000000000000000
Valid from 00.00.0000 to 00.00.0000