CERTIFIED TRANSLATION FROM SERBIAN INTO ENGLISH BEGINS:

Form number 6
The tax pursuant to Article 19 of the Law on Republic Administrative Fees was not charged.
[COAT OF ARMS]
REPUBLIC OF SERBIA
CITY ________________________
MUNICIPALITY OF SREMSKA MITROVICA
BIRTH CERTIFICATE
In the Register Book of Births, kept for SREMSKA MITROVICA registry area, under the file number ___, for
the year of ___, a birth was registered for:
Name Gender: MALE
Surname
Day, month, year and time of birth
Place and municipality of birth, and if born
abroad, please state the country
Citizen’s Personal ID Number
Citizenship REPUBLIC OF SERBIA
Information about parents Father Mother
Nationality ///
Name
Surname (mother’s maiden name)
Citizen’s Personal ID Number
Day, month, year and time of birth
Place and municipality of birth, and if the
person was born abroad, state the country
Citizenship
Place of residence and apartment address
Additional inserts and notes: ///

Number: _______
In SREMSKA MITROVICA, on __ May Registrar’s signature
2024 [Signed. The handwritten signature is illegible]

[The place of the round official seal: /Coat of arms/ Republic of Serbia – Autonomous Province of
Vojvodina, Sremska Mitrovica - illegible]

Printed by: NBS – Institute for manufacturing of banknotes and coins - Topčider

2 2862097