Letter Of Certification Chusak Phuttharak

  • October 2019
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  • Words: 207
  • Pages: 2
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LETTER OF CERTIFICATION To Whom It May Concern, I, the undersigned, ORAWAN SOMBOUNE, was born on April 14,1963. I am residing at No. 8/31 Burapa 7, Moo 5, Srikan, Donmueang Bangkok, Thailand. I ,hereby, declare that: Since the year of 1995, I had cohabited with Mr. CHUSAK PHUTTHARAK, who was born on August 10,1965. We lived together without register for marriage until the year 2004, our cohabitation terminated. We have a common daughter name : Date of Birth: Place of Birth:

ONVANYA PHUTTHARAK 12/27/1997 Bangkok, Thailand.

I, ORAWAN SOMBOUNE, give my consent to my daughter to come to the United States to live with her father. I certify that the above declaration is true and correct. I can be prosecuted before the court of law for any false statement. Following are two witnesses, who acknowledge my situation and the cohabitation between myself with MR. CHUSAK PHUTTHARAK. Sincerely yours,

Orawan Somboune

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First Witness Full name: Weera Phuttharak Date of Birth: 08/1961 ID No. 5331090005529 Address: 111/250 Ammarinnvet 3, Saimai Rd, Saimai District, Bangkok, Thailand

__________________ Signature of witness

Second Witness Full name: Arree Veerasai Date of Birth: 02/26/1943 ID No. 3101401744081 Address: 111/250 8/31 Burapa 7, Moo 5 Srikan, Donmueng , Bangkok,Thailand

________________________ Signature of witness

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