Справка о смерти супруга

Oopsy

Translated from Russian
Repeated
CERTIFICATE OF DEATH

The citizen IVANOV
Surname

Ivan Ivanovich
Name, patronymic

died on 11 August 1996
Nineteen ninety six

at the age of 44
in witness whereof the entry of death was made in registry book under number 1234
on 12 August 1996
Cause of death large intestine cancer

Place of death: city Saint-Petersburg
District Vyborgsky
Republic Russian Federation

Place of registration Vyborgsky Civilian Registry Office of Saint-
Petersburg

Date of issue 26 November 1996

Chief of Registry Office /signature/
Seal: Saint-Petersburg City Administration * Administration of Vyborgsky district * Civilian Registry
Office
II – AK № 123456

APOSTILLE
(Convention de La Haye du 5 octobre 1961)

The Russian Federation
This public document
has been signed by Lebedeva
acting in the capacity of Chief of Civilian Registry Office
bears the seal/stamp of the Civilian Registry Office of Vyborgsky district of Saint-Petersburg

CERTIFIED:
5. at Saint-Petersburg 6. on 17.05.2004
7. by Lykova, Specialist of Department of Civilian Registry Offices of Saint-Petersburg
8. № 1234
9. Seal/stamp
10. Signature ___________________________________
/signature/
Seal: Seal: Saint-Petersburg Government * Department of Civilian Registry Offices * INN 1111111111 * OGRN 11111111111111 * OKPO 11111111
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I, Duwaine Elena, certify that I am fluent in the English and Russian languages, and that the above (or attached) document is an accurate translation of the document attached entitled.

Signature ____________________________

Date ____________________________

Address: 1111 NE 11th Street
Tampa
FLORIDA 11111
_________________