Consulate General of Arab Republic of Tel: (212) 759-7120 Egypt Fax: (212) 308-7643 1110 Second Avenue New York. N.Y 10022 No. ( ) TRUE TRANSLATION OF A OF A DEATH CERTIFICATE Death Certificate Issued from : Name of Deceased : Sex : Mother's Name : Place of Death : Date of Death : Age of Deceased : Religion : Marital Status : Occupation : Nationality : Place of Residence : This death certificate is registered in the Ministry of Health, Civil Registry of _______________, Egypt under No. ______________ on __________________. Officer in Charge Registrar’s Office Issued on: Seal of the Ministry of Interior This is a true translation of an original Egyptian document without any responsibility towards the Consulate of Egypt in New York as to its contents. CONSUL GENERAL New York, USA Date: