Main Department of the
Ministry of Internal Affairs
of the Russian Federation
for the city of Moscow
No. 38, Petrovka str. Moscow, 127994
tel. (495) 694-97-23
fax. (495) 698-65-14
CERTIFICATE
SERIES ___ No. __________ dated ____________ File No. ___________
is issued to ______________, Apt. ___, No. ___, ______ str., Moscow, Russia
The Main Informational and Analytical Center of the Ministry of Internal Affairs of Russia,
Main Department of the Ministry of Internal Affairs of Russia for the city of Moscow, Main
Department of the Ministry of Internal Affairs of Russia for the Moscow Region have
no information on any criminal records regarding
________________________________________
date of birth: ____________,
place of birth: the city of__________, on the territory of the Russian Federation.
Additional information: N/A.
Signature:
Zonal Information Center
Head
_____________________