SOCIALIST REPUBLIC OF VIETNAM Independence-Freedom-Happiness BAC NINH PROVINCE FAMILY HOUSEHOLD REGISTERING BOOK N°:1709 Name of the head of household: …………………… House N°:…………………………………………… HEAD OF HOUSEHOLD Full name : ………………………… Date of birth : ………………………… Place of birth : ………………………… Sex :………………………… Native place : ………………………… Ethnic group : ……………………… Religion : ………………………… ID Card N° : Occupation : ………………………… Place of work : ………………………… 10.Date of Moving in : Former address : 11.Date of moving out :………………………… Place of moving to :…………………………… Street, Hamlet : …………………………………… Commune/Precinct: ……………………………… District : …………………………………………… No 01 Page: 53 12 Office of registering household September 07, 2001 (Name, position, sign and seal) On behalf of the Chief of Public Security Do Dang Sang (Signed and sealed) RELATIONSHIP TO THE HEAD OF HOUSEHOLD :MOTHER RELATIONSHIP TO THE HEAD OF HOUSEHOLD :WIFE 1.Full name Nick name Date of birth Place of birth Sex Native place Ethnic group Religion ID Card N° : Nguyen Thi Gia………………… : ……………………………………… : December 15, 1925 ………………… : …………………… : Female…………………………… : …………………………… : Kinh………………………………… : ……………………………………… : ……… 1.Full name Nick name Date of birth Place of birth Sex Native place Ethnic group Religion ID Card N° : Nguyen Thi Tinh………………… : ……………………………………… : Ferbruary 12th, 1964 ………………… : Ba hamlet, Mao Dien………………… : Female…………………………… : Thuan Thanh- Bac Ninh……………… : Kinh………………………………… : None………………………………… : ……… Occupation Place of work : Farmer…………… :Mao Dien………………………………… Occupation Place of work : Farmer…………… :Mao Dien………………………………… 10 Date of Move in : ………………………………………… Former address : ………………………………………… 11 Date of moving out :…………………………………………… 10 Date of Move in : ………………………………………… Former address : ………………………………………… 11 Date of moving out :…………………………………………… Place of moving to :……………………………………………… Place of moving to :……………………………………………… 12 Office of registering September 07, 2001 household May 13th, 1996 On behalf of the Chief of PublicSecurity Do Dang Sang (Name, position, sign and seal) (Signed and sealed) Date of moving out: Died of ill on December, 31st,2004 September 31st , 2004 On behalf of the Chief of Public Security Do Dang Sang (Signed and sealed) 12 Office of registering household September 07, 2001 On behalf of the Chief of PublicSecurity Do Dang Sang (Signed and sealed) RELATIONSHIP TO THE HEAD OF HOUSEHOLD :SON 1.Full name Nick name Date of birth Place of birth Sex Native place Ethnic group Religion ID Card N° : Nguyen Xuan Vinh………………… : ……………………………………… : December 1st , 1990 ………………… : Man hamlet, Mao Dien……………… : Male…………………………… : Thuan Thanh- Bac Ninh……………… : Kinh………………………………… : None……………………………… : 125295976……… Occupation Place of work : Pupil…………… :Mao Dien………………………………… 10 Date of Move in : ………………………………………… Former address : ………………………………………… 11 Date of moving out :…………………………………………… Place of moving to :……………………………………………… 12 Office of registering household September 07, 2001 On behalf of the Chief of Public Security (Name, Position, sign and seal) Do Dang Sang (Signed and sealed) (Name, position, sign and seal) RELATIONSHIP TO THE HEAD OF HOUSEHOLD :SON 1.Full name Nick name Date of birth Place of birth Sex Native place Ethnic group Religion ID Card N° 9.Date 10.Place : Nguyen Xuan Vung………………… : ……………………………………… : December 11, 1984 ………………… : Man hamlet, Mao Dien……………… : Male…………………………… : Thuan Thanh- Bac Ninh……………… : Kinh………………………………… : None……………………………… : 125092240……… :March 22nd , 2000 : Bac Ninh Public Security 11 Occupation Place of work : Farmer…………… :Mao Dien………………………………… 12 Date of Move in : ………………………………………… Former address : ………………………………………… 13 Date of moving out :…………………………………………… Place of moving to :……………………………………………… 14 Office of registering household September 07, 2001 On behalf of the Chief of Public Security Do Dang Sang (Signed and sealed) RELATIONSHIP TO THE HEAD OF HOUSEHOLD :DAUGHTER 1.Full name Nick name Date of birth Place of birth Sex Native place Ethnic group Religion ID Card N° 9.Date 10.Place : Nguyen Thi Vinh………………… : ……………………………………… : May 19th , 1988 ………………… : Man hamlet, Mao Dien…………… : Female…………………………… : Thuan Thanh- Bac Ninh……………… : Kinh………………………………… : None………………………………… :125255184 ……… :January 7th ,2004 : Bac Ninh Public Security 11 Occupation Place of work : Pupil…………… :Mao Dien………………………………… 12 Date of Move in : ………………………………………… Former address : ………………………………………… 13 Date of moving out :…………………………………………… Place of moving to :……………………………………………… 14 Office of registering household September 07, 2001 On behalf of the Chief of Public Security Do Dang Sang (Signed and sealed)