USI tc INS "- CHI CA.GO IL J.. -Place: (last) . FATHER 1S NA1-rE: .. MOTHER I S NAME: PJ.ace:' .~ . . ' Magistrate.: -.(~~1 name) ~ .CERTIFICATE FOUND: Archive or Register:Page. No. . NOTATIONS OF IMPORTANCE: I, 'Co") ~~~~~ ~':' ~:_=._-~: ' hereby certify that the above i~; an accurate translation of, the original "birth certificate" in c**} , i and that :r am competent in both English and C**) -7' -== = ~ render such translation. , Date ; Ii 1 5. 3. 4. 6. .2. 7.' NAME: -"Date: BIRTH: TRANSLATION OF A DEATH CERTIFICATE --(first/middle/last) PLACE: -- (city or town I state or province I country) ~ --- (month/day/year) ~ Spouse of the deceased at the time of his/her death: (first/middle/last) -Official who signed the Certificate of Death, Doctor or Clerk: (first/middle/last) CERTIFICATE ISSUED: ~ --- (month/day/year) (city, State, Country) MAGISTRATE : CERTIFICATE FOUND: Archive or Register: PAGE: NO: - I NOTATIONS OF IMPORTANCE: CERTIFICATION OF TRA1~SLATOR' S COMPETENCE I, , hereby certify that the above is an accurate translation of the original birth certificate in Spanish and that ~ am competent in both English and Spanish to render suchtranslation --- (signature of translatOr) Agency: I I . NAME: DATE: PLACE: DEATH: t TRANSLATION OF A "MARRIAGE CERTIFICATE" (print or type) u 1. Mr.. & (first name"). (middle) (last)~ Ms./Mrs. (first name) (middle). (last) .. u 2. WERE MARRIED: on (month) (day) (year) 3. in 4. by -.(Judge or Minister's full name) 2) - (first name) (middle) (last) CERTIFICATE ISSUED: By --Magistrate or Ministe~ .. 7. 8. }: 9. CERTIFICATE FOUND: Archive or Register: "Ii Page No. 9. IMPORTANT NOTATIONS: CERTIFICATION OF TRANSLATOR' S COMPETENC~ ~, (*) 0 ' hereby certify that the above ~S an accurate translation of the original "marriage certificate- in (**) , and that I am competent in both English and (**) to render such translation. -- Date (Signature of Translator) (') Printed or typed, name of the translator in full. (") Language of the original certificate -Spanish, French, German, etc. Chinese, A copy of the original Note, doc=ent should be attached to this summary translation form and certification. 1, 5. 6.
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