ENGLISH TRANSLATION OF BIRTH CERTIFICATE

NAME OF REGISTERED CHILD: ________________________________

DATE OF BIRTH: ________________________________

PLACE OF BIRTH: ________________________________

Father of Child: ________________________________

Age of Father: ________________________________

Nationality of Father: ________________________________

Mother of Child: _______________________________

Age of Mother: _______________________________

Nationality of Mother: _______________________________

PLACE AND DATE OF REGISTERED: _______________________________

Book, Volume, and Number: _______________________________

I, ________________________________, ATTEST TO MY COMPETENCY TO

TRANSLATE FROM SPANISH TO ENGLISH, AND I CERTIFY THAT THIS IS
A CORRECT ENGLISH TRANSLATION OF ALL PERTINENT INFORMATION
FROM THE SPANISH ORIGINAL.

______________________________________ ________________
Signature: Date