Model Criminal Record

Certified translation from Romanian into English

ROMANIA Series No.

MINISTRY OF ADMINISTRATION AND HOME AFFAIRS

POLICE SUPERINTENDENCE, County

Fiscal stamp

-Criminal RecordNotification for issuing personal data no. 1110

Illegible stamp

CERTIFICATE OF CRIMINAL RECORD Number NO of DATE Name

First name

Date of birth

Personal identification number Place of birth Last residence

The holder is not registered in the criminal record book. This certificate was issued to be used for:

Head of criminal record department, Police Chief Commissioner Stamp and illegible signature CONFIDENTIAL! OBSERVATION! Personal data, issued according to Law no. 677/2001