Certified translation from Romanian into English of a copy.

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ROMANIA
MINISTRY OF ADMINISTRATION AND HOME AFFAIRS Seri es ...... No. .............
POLICE SUPERINTENDENCE
-Criminal Record-
Notification for issuing personal data no. .




CERTIFICATE OF CRIMINAL RECORD

Number of

October, 20
th
2011
Name


First name

.
Personal identification number

.
Date of birth

Year: month . day .
Place of birth

.
Last residence

county, .. town, .. street, no, bl. ., stair ,
ap.


The holder is not registered
This certificate was issued to be used:
in the criminal record book.
ABROAD FILE

.

Stamp + illegible signature
Head of criminal record department,
CONFIDENTIAL

OBSERVATION! Personal data issuing, issued according to Law no. 677/2001


************
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Fiscal
stamp

Fiscal
stamp
Illegible
stamp

Illegible
stamp