SOCIALIST REPUBLIC OF VIETNAM

Independence - Freedom - Happiness

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HOUSEHOLD BOOK
 HOUSEHOLDER
PUBLIC SECURITY OF PHU YEN
Full name: NGUYEN THI THANH THUY
Other full name (if any): ……………………………………….
Date of birth: 05/11/1975 Sex: Female
Native place: Ward 2 – Tuy Hoa City – Phu Yen
HOUSEHOLD BOOK Ethnic group:Kinh Religion: Vietnamese.
No.: 460022754 Occupation, work place: ……………………………………….
Permanent residence before arriving: separation of households in
the same house
Full name of the householder: NGUYEN THI THANH
THUY
Permanent residence: Lot D38 – HUNG PHU URBAN 25th/June/2016
REGISTRAR
AREA – WARD 5 – TUY HOA City
(Signed) Deputy Chief of Public Security of
Tuy Hoa City
Lieutenant Colonel Do
25 /June/2016
th
Thi Hoai Thuong (Signed and sealed)
Deputy Chief of Public Security of Tuy Colonel Tran Van Hieu
Hoa City ____________________________________________________
(Signed and sealed) Reason for deleting the permanent registration: ………………………….....
Colonel Tran Van Hieu …………………………………………………………………….
REGISTRAR Date ………………………
(Full name and signature) CHIEF OF…
PUBLIC SECURITY
Household file No.: ………………………………………….. …………………………
Permanent registration Book No.: ……… Sheet No.:……… (Signature and seal)

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 RELATION WITH HOUSEHOLDER: DAUGHTER RELATION WITH HOUSEHOLDER: DAUGHTER

Full name: LE PHUONG ANH Full name: LE HUU THIEN AN

Other full name (if any): ………………………………………. Other full name (if any): ……………………………………….
Date of birth: 01/12/2000 Sex: Female Date of birth: 12/02/2012 Sex: Female
Native place: Da Nang City Native place: Da Nang City
Ethnic group:Kinh Religion: Vietnamese Ethnic group:Kinh Religion: Vietnamese
Occupation, work place: ……………………………………… Occupation, work place: ………………………………………
Permanent residence before arriving: separation of households Permanent residence before arriving: separation of households
in the same house in the same house

25th/June/2016 25th/June/2016
REGISTRAR REGISTRAR
(Signed) Deputy Chief of Public Security of (Signed) Deputy Chief of Public Security of
Tuy Hoa City Tuy Hoa City
Lieutenant Colonel Do Lieutenant Colonel Do
Thi Hoai Thuong (Signed and sealed) Thi Hoai Thuong (Signed and sealed)
Colonel Tran Van Hieu Colonel Tran Van Hieu

___________________________________________________ ___________________________________________________
Reason for deleting the permanent registration: ………………………….. Reason for deleting the permanent registration: …………………………..
…………………………………………………………………. ………………………………………………………………….
REGISTRAR Date ……………………… REGISTRAR Date ………………………
(Full name and signature) CHIEF OF… (Full name and signature) CHIEF OF…
PUBLIC SECURITY PUBLIC SECURITY
………………………… …………………………
(Signature and seal) (Signature and seal)

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 RELATION WITH HOUSEHOLDER: SON RELATION WITH HOUSEHOLDER:

Full name: LE HUU DUY ANH Full name:

Other full name (if any): ………………………………………. Other full name (if any): ……………………………………….
Date of birth: 19/06/2015 Sex: Male Date of birth: Sex:
Native place: Da Nang City Native place:
Ethnic group:Kinh Religion: Vietnamese Ethnic group: Religion: ………………..
Occupation, work place: ……………………………………… Occupation, work place: ………………………………………
Permanent residence before arriving: separation of households Permanent residence before arriving:
in the same house

25th/June/2016 …/…/……
REGISTRAR REGISTRAR
CHIEF OF …
(Signed) Deputy Chief of Public Security of (Signed)
PUBLIC SECURITY
Tuy Hoa City …
(Signed and sealed)
Lieutenant Colonel Do …
Thi Hoai Thuong (Signed and sealed)
Colonel Tran Van Hieu

___________________________________________________ ____________________________________________________
Reason for deleting the permanent registration: ………………………….. Reason for deleting the permanent registration: ………………………….....
…………………………………………………………………….
………………………………………………………………….
Date ……………………… REGISTRAR Date ………………………
REGISTRAR
(Full name and signature) CHIEF OF…
(Full name and signature) CHIEF OF…
PUBLIC SECURITY
PUBLIC SECURITY
…………………………
…………………………
(Signature and seal) (Signature and seal)

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