Date   of Birth

February   27^th, 1983

October   5^th, 1986

Resident   Identity Card Number

Nationality

China

China

Ethnicity

Han

Han

Occupation

Staff   and relevant personnel

Staff   and relevant personnel

Education

University/College

University/College

Reason   for Divorce

Others

Documents   provided

The   man’s side: Resident Identity Card, Residence Booklet, Marriage Certificate, Divorce   Agreement Letter, Photo, Declaration Letter

The   woman’s side: Resident Identity Card, Residence Booklet, Marriage   Certificate, Divorce Agreement Letter, Photo, Declaration Letter

Inspection   Opinion

It   conforms to divorce requirement, and is approved for divorce registration

Divorce   Registration Date

October   30^th, 2013

Divorce   Certificate Number

L110105-2013-007334

Print   Number of Divorce Certificate

0040769351

0040769352

Registration   Unit Name

Marriage   Registration Division, Civil Administration Bureau, Chaoyang District

Register   Signature

                            October 30^th, 2013

The   person involved receiving certificate signature or fingerprint

The   man’s side:

October   30^th, 2013

The   woman’s side:

         October 30^th, 2013

Remarks