Birth Certificate Translation Template

1. NAME: __________[Full Name]_________
2. BIRTH PLACE: __(city/town)   (state/province)       (country)___
3. Birth Date: _____MM / DD / YYYY_____
4. Father’s Name: _____[Full Name]_____
   Father’s Age: ________________________
   Father’s Nationality: _________________
5. Mother’s Name: _____[Full Name]_____
   Mother’s Age: ________________________
   Mother’s Nationality: _________________
6. Certificate Issued:
   Place Registered: __(city/town)   (state/province)       (country)___
   Date Registered: _____MM / DD / YYYY_____
   Magistrate: _____[Full Name]_____
7. Certificate Found (Archive or register):
   Book No.: ________________
   Page: ___________________
   Ref.: ____________________
8. NOTATIONS OF IMPORTANCE:
   ___________________________________________________________
   ___________________________________________________________

CERTIFICATE OF TRANSLATOR'S COMPETENCE

I, _______________________________ certify that I am competent to translate from [fill in the language of the document] to English and that the above translation of the original "Birth Certificate" is a complete and accurate translation to the best of my knowledge and belief.

Signed: [Signature translator]
Print: (Printed name of translator]

Address: __________________________________
Telephone: ________________________________
Date: _____________________________________