Book No. 140 Document No. 26229/2543
This is to certify that:
Miss Jintana Kularbwong
Residing at House No. : 295/137 Road, Lane or Alley: ………………………. Moo : 9
District: Bangkaso Amphur: Muengnonthaburi Province: Nonthaburi
Father’s Name: Sawong Mother’s Name: Sumalee
Has been granted permission to change the personal name to “ Pornsarun “
The District Registrar hereby issued this certificate as evidence.