*

F arnity name act

MLAY

Green names

ERICK HERIAD

date of berth

**/**/****

Date of esue0 “i ate of onge

**/**/**** ***

issuing authorty

TANZANIA REVENUE AUTHOR

Permanent piace of ps chenor

Dar es Salaam

Categones of Vermces

BODE

— E HM

eet

oni