ENGLISH TRANSLATION

Copy

People’s Commissariat of Inner Affairs of USSR

File Department of national (citizen) affairs (acts)

USSR

People’s Commissariat of

Inner affairs DEATH CERTIFICATE # 1418

NKVD (People’s Commissariat of Inner Affairs) of the city of Moscow

Frunzensky district bureau ZAGS ( Government Service)

19.III – 1942year. Citz. PERVIN Samuel Yakovlevitch died on 15th of March

Moscow city nineteen hundred forty two, about what in the records book of national affairs was made a corresponding record of death on 1942, 18^th of March.

　

The place of death: Moscow city. Frunzensky district

Age and cause of death – 82years. Old age. Feebleness.

The Chief executive of ZAGS bureau -- signature

The file keeper (maker) -- signature

SEAL: Bureau of records of national affairs

Frunzensky district.

ENGLISH TRANSLATION

STEMP: 1942 y. month of March, 23^rd. I am a federal notary of the 1^st Moscow Federal office, Koreunova ?. N. certify a truthfulness of an identity of the information contained in this copy with the information contained on the original document which was presented in this office by a citizen Romanova C. E. residing in the Moscow city. Khorosh…??….? 2, app. 6.

When comparing the present copy with the original document, the latter does not contain any corrections, erased information, added to the original writing information, crossed out words, and other particularities.

Charged EGP(?): 1 ruble, for technical service: 2 rubles at 23, iii, 1941y.

(Ineligible writing) 6806 …………14795

Notarious…………(signature)

SEAL of the Federal Notary office #1.