PEOPLE’S COMMITTEE Precinct / Commune: …… District : ……………… Province : ……………… SOCIALIST REPUBLIC OF VIETNAM INDEPENDENCE – FREEDOM - HAPPINESS   Form TP/HT-1999-A.2.a No : ……………… Book No.: ……………… BIRTH CERTIFICATE (DUPLICATE) Name in Full Date of Birth Place of Birth Ethnic Group : : : : ……………………… ……………………… ……………………… ……………………… PARENTS’ DETAILS Name in Full Date of Birth Ethnic Group Nationality Residence Gender : ……………………… Nationality : Vietnamese FATHER ……………………… ……………………… ……………………… ……………………… ……………………… MOTHER ……………………… ……………………… ……………………… ……………………… ……………………… Full name, Age, Identification Card No of Informant: ……………………… Informant (Signed) ……………………… Registration on ………………… On behalf of People’s Committee of …………… Chairman (Signed and Sealed) ……………………… DUPLICATED FROM BIRTH CERTIFICATE REGISTRATION BOOK (place), (date) On behalf of ………………… ……………… (Signed and Sealed) ……………………