Certified English Translation A11474/05-11-03 e Registration B1 (High Reg. P&SC)278 No. 6455 SRILANKA CERTIFICATE OF BIRTHS Births and Deaths Registration Act (Cap. 110) District:- Kalutara Division: Kalutara Town 1, Date and Place of Birth Fifth of September 1987 (Eighty Seven) General Hospital, Kalutara 2. Name Marlon Trevin 3. Sex Male Full Name ‘Samarappuli Chandra Siripala Fernando Date of Birth Seventeenth of May 1947 4 Father's < Place of Birth Denipitiya Race ‘Sinhalese Rank or Profession Teaching Full Name Jayasekara Gajahin Gamage Ramani Kanthi Date of Birth ‘Twenty Fifth of June 1956 5.Mother’s Place of Birth Pathegama_ Race Sinhalese ‘Age ‘Thirty One Years 6. Were Parents Married ‘Yes his full Name Samarappuli Coraneris Fernando 7.1 Grand father ‘Bom in Sri Lanka his year of birth 1916 his place of birth Kalutara vows 2.03 4 2 OMe nia 5358 38, ani8. Ifthe father was notbom in [his full Name Sri Lanka and if great year of birth Father bor in SriLanka, | place of birth the grand father Father was bor in Ceylon 9. Informant's full name residence and Jn what capacity he gives information ‘Samarappuli Chandra Siripala Femando Panwila Kalutara (Father) 10, Informant’s Signature ‘Signature illegible 11, Date of Registration 12. Registrar's Signature 13. Name inserted or substituted after registration 14. Name of person on whom Information particular relating to item 13 were supplied and in ‘what capacity to information ‘Ninth of November 1987 (Eighty Seven) Sed. MH.Senaramne 15. Date of insertion or substitution and District Registrar or Registrar General's Signature 1 do hereby certify that the foregoing is a true copy ofa birth registration entry filed of record in this office District Registrar Section Divisional Secretariat Kalutara Sgd. legible Date: 07-11-2005 Additional District Registrar Seal PDS. Ranjanic Photocopied by: Sed. Ilegibly Additional District Registrar Compared by: Sgd. Ilegibly Kalutara Itis hereby certified that the foregoing is a true and accurate English Translation of the Birth Certificate No. 6455 issued in Sinhala Date: 26" August 2014 Qn f Swom Translator 8. $. Sc. ENG. 8. LJ.P. “INDO TADDUWA. orsansisn ose agge4ss Disraior cour.