Han xxx, female, Han nationality, born on May xx, 1988, ID card No. is xxxxxx51723xx, whose place of domicile is Group 9, xx Committee, xx Street, xx District, Tonghua City, Jilin Province. During her residence in our governing district, there is no criminal record. It is hereby verified.

 

(Seal) xx Branch of xx City Public Security Bureau

xx Police Station

November 14, 2016

 

晗xx，女，汉族，1988年X月X日出生，身份证号为xxxxxx，该居民户籍所在地为吉林省xxxx,她在我辖区居住期间，暂未发现有前科劣迹，情况属实。

 

通化市公安局东昌区分局 XX派出所。2016年11月14日