STATE OF NEW YORK                    )
                                                     )  SS:
COUNTY OF NEW YORK                 )
 

I,  (full name of translator)      , being duly sworn, deposes and says that I am familiar with both the English and the Japanese languages, and that I have made English translation from the following attached document in regard to:
     (full name of the individual that the document applies to)       :

Abstract of Census Register (Japanese Family Registry) of (last name of the individual that the document applies to) 

from the  Japanese  language, and hereby certify that the same is a true and complete translation to the best of my knowledge, ability and belief.
 
 

 
    (signature of the translator)    .
    (full name of the translator)                        (date)        . 
 
 

Sworn And Subscribed Before Me On The

                        of                        , 20                .     .
 
 
 
 

                                                                            .
Notary Public In and For The State of New York