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SOCIALIST REPUBLIC OF VIETNAM Independence-Freedom-Happiness TAY NINH PROVINCE FAMILY HOUSEHOLD REGISTERING BOOK N°: 040011471 Name of householder: LE VAN DEO HOUSEHOLDER Full name: LE VAN DEO Sex: male Other name :………………………… Date of birth: August 8, 1956 Place of birth: Loc Hung Native country : Trang Bang Ethnic group : Kinh Religion: none Occupation, Place of work : Farmer ID Card No.: 290247687 Date of issue: July 16, 1979 Place of issue: Tay Ninh Police Service Move-in Date: …………………………… Permanent place of residence before move-in: change into another book House No.:…………………………………………… Street, Hamlet : Loc Thanh Registration officer (Name and signed) Commune/Ward/Town: Loc Hung District/ Town: Trang Bang HSHK No 107002844 November 29, 2006 The Chief of the village Police (Signed and stamped) Pham Van Mat Vo Van Pheo RELATIONSHIP WITH HOUSEHOLDER: WIFE RELATIONSHIP WITH HOUSEHOLDER: DAUGHTER Full name: HO NGOC CAM Sex: female Other name:………………………… Date of birth: December 1, 1955 Place of birth: Loc Hung Native country: Trang Bang Ethnic group: Kinh Religion: none Occupation, place of work: Farmer ID Card No.: 290247713 Date of issue:…………… Full name: LE THI HUYEN Sex: female Other name:………………………… Date of birth: February 19, 1978 Place of birth: Loc Hung Native country: Trang Bang Ethnic group: Kinh Religion: none Occupation, Place of work: ID Card No.: 290011471 Date of issue: July 19, 2004 Place of issue: …………… Place of issue: Tay Ninh Police Service Move-in Date: ……………… Permanent place of residence before move-in: change into another book Move-in Date: ……………………… Permanent place of residence before move-in: change into another book Registration officer (Name and signed) November 29, 2006 The Chief of the village Police Registration officer (Name and signed) (Signed and stamped) Pham Van Mat Vo Van Pheo November 29, 2006 The Chief of the village Police (Signed and stamped) Pham Van Mat Vo Van Pheo RELATIONSHIP WITH HOUSEHOLDER: DAUGHTER RELATIONSHIP WITH HOUSEHOLDER: SON Full name: LE THI KIM HUYEN Sex: female Other name:………………………… Date of birth: April 28, 1982 Place of birth: Loc Hung Native country: Trang Bang Ethnic group: Kinh Religion: none Occupation, Place of work : ………………………… ID Card No.: 290692877 Date of issue : June 4, 1997 Full name: LE HOANG QUY Sex: male Other name:………………………… Date of birth: September 10, 1984 Place of birth: Loc Hung Native country: Trang Bang Ethnic group : Kinh Religion: none Occupation, Place of work: Farmer ID Card No.: 290769750 Date of issue: March 22, 2000 Place of issue: Tay Ninh Police Service Place of issue Move-in Date : …………………… Permanent place of residence before move-in: change into another book Move-in Date:………………… Permanent place of residence before move-in: change into another book Registration officer (Name and signed) Pham Van Mat November 29, 2006 The Chief of the village Police (Signed and stamped) Vo Van Pheo Date of moving out: May 25, 2007 Place of moving in: Gia Tan hamlet, Gia Loc village, Trang Bang district, Tay Ninh province Registration officer (Name and signed) May 25, 2007 The Chief of the village Police (Signed and stamped) Nguyen Thi Truc Linh Nguyen Thanh Son : Tay Ninh Police Service Registration officer (Name and signed) Pham Van Mat November 29, 2006 The Chief of the village Police (Signed and stamped) Vo Van Pheo RELATIONSHIP WITH HOUSEHOLDER: GRANDCHILD RELATIONSHIP WITH HOUSEHOLDER: DAUGHTER-IN LAW Full name: TRAN LE NI NI Sex: female Other name: Tran Le Ni Ni Date of birth : July 3, 2007 Place of birth: Tay Ninh General Full name : PHAN THI TUYET LAN Sex: female Other name :………………………… Date of birth : 1990 Place of birth: Native country: Hung Thuan village, Trang Bang district Tay Hospital Native country : Loc Hung village, Trang Bang district Ethnic group: Kinh Religion: none Occupation, Place of work : ………………………… ID Card No.: …………… Date of issue : ………… Place of issue :………………… Move-in Date : ………………… Permanent place of residence before move-in: registration of birth Registration officer December 28, 2007 (Name and signed) The Chief of the village Police (Signed and stamped) Nguyen Thi Truc Linh Ninh province Ethnic group : Kinh Religion: none Occupation, Place of work: Farmer ID Card No.: 290930932 Date of issue:…………… Place of issue:………………… Move-in Date : June 8, 2011 Permanent place of residence before move-in: Cau Xe hamlet- Hung Thuan village-Trang Bang district - Tay Ninh province Registration officer (Name and signed) Vo Van Pheo June 8, 2011 Vice Chief of the village Police (Signed and stamped) Tran Van Nguon Tran Van Tay RELATIONSHIP WITH HOUSEHOLDER: GRANDSON Full name : LE PHAN TRUC LY Sex: female Other name: ……………… Date of birth : September 11, 2009 Place of birth: Cu Chi Hospital - Ho Chi Minh city Native country: Loc Hung village, Trang Bang district Ethnic group : Kinh Religion: none Occupation, Place of work : ………………………… ID Card No.:……………… Date of issue:…………… Place of issue : Move-in Date: June 8, 2011 Permanent place of residence before move-in: registration of birth Registration officer (Name and signed) June 8, 2011 Vice Chief of the village Police (Signed and stamped) Tran Van Nguon RELATIONSHIP WITH HOUSEHOLDER: GRANDSON Full name : LE PHAN HOANG KY Sex: male Other name :………………………… Date of birth : May 20, 2011 Place of birth:Tu Du Hospital _ Ho Chi Minh city Native country : Loc Hung village, Trang Bang district ,Tay Ninh province Ethnic group : Kinh Religion: none Occupation, Place of work : ………………………… ID Card No.: ………………… Date of issue : ………… Place of issue: ………………… Move-in Date : June 8, 2011 Permanent place of residence before move-in: : registration of birth Registration officer (Name and signed) June 8, 2011 Vice Chief of the village Police (Signed and stamped) Tran Van Tay Tran Van Nguon Tran Van Tay