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PEOPLE’S COMMITTEE PEOPLE’S COMMITTEE Commune/ward District Province/City SOCIALIST REPUBLIC OF VIETNAM Independence Freedom Happiness BTP/HT 12345 KS 2 No Book CERTIFICATE OF BIRTH Full name Sex Date[.]

PEOPLE’S COMMITTEE Commune/ward: District: SOCIALIST REPUBLIC OF VIETNAM BTP/HT12345-KS.2 Independence- Freedom- Happiness No: Book: Province/City: CERTIFICATE OF BIRTH Full name: Sex: Date of birth: In words: Place of birth: Ethnic group: Nationality: Native village: Full name of father: Ethnic group: Nationality: Full name of mother: Ethnic group: Nationality: Full name of declarant: RRelationship with declarant: DECLARANT (Signed) Civil StatusJudicial Officials (Signed) Dated Instate People’s Committee PP CHAIRMAN (Signed and sealed)

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