Death certificate for Abdulrahman al-Awlaki and false State Department claim that cause of death is "unknown"

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05191419 Date: 09/14/2012 نموذج رقم (١٣/٦ م) RELEASED IN PART B6 الرسوم ١٢٠ ريال 037352 ط ٢٠١٠ الجمهورية اليمنية وزارة الداخلية مصلحة الأحوال المدنية والسجل المدني شهادة وفاة إدارة أحوال مدنية : [الحوطة] مديرية : [طور] محافظة : [لحج] REVIEW AUTHORITY: Sharon Ahmad, Senior Reviewer UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05191419 Date: 09/14/2012

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05191419 Date: 09/14/2012

بيانات المتوفي بيانات الوفاة ١٩٢ ٠١١/١١/١٦

بيانات البطاقة

محل الإقامة المعتادة

بيانات الأم

القيد بالسجل المدني

سجلت الواقعة بسجل واقمة الوفاة رقم ٩٥ وتاريخ ٢٠١١ / ١١ / ١٦ م إدارة أحوال مدينة أبين مديرية أب محافظة أب إسم المسجل : محمد ذان محمد إسم مدير الأحوال المدنية : عبد الله محمد توقيع توقيع الختم

B6

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05191419 Date: 09/14/2012

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05200799 Date: 09/14/2012

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RELEASED IN PART B6

U.S. Department of State Office of Language Services Translating Division

LS No. 08-2012-0384-B Arabic/English MG/ SK Republic of Yemen, Death Certificates – Abdul Rahman Al-'Awlaki

TRANSLATION

Form number (6/ 3 Alif. Mim)

037352 Ta/2010

Fees 120 Riyals

Official Emblem

Republic of Yemen Ministry of Interior Civil Status Authority and Civil Registry

Death Certificate

Civil Status Department: The Main Office District: . . . . . . . . . . Governorate: Sanaa REVIEW AUTHORITY: Sharon Ahmad, Senior Reviewer

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05200799 Date: 09/14/2012

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05200799 Date: 09/14/2012

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[Rectangular stamp showing a registration number of 19363 and a date of: 11/14/2011] [Rectangular stamp showing an illegible signature and the date, 11/14/2011]

Deceased Data: Deceased's Full Name: First name: Abdul Rahman Father's Name: Anwar Grandfather's Name or Surname: Al-'Awlaki Sex: male / female: Male Religion: Muslim Nationality: U.S. Citizen Date of Birth: Ninety Five

Death Data: Date of death written in letters: October Fourteenth, Two Thousand and Eleven, A.D. Place of Death: Village or Town: . . . . . . . . District: . . . . . . . . . . Governorate / State: Shabwa

Marital Status: Single Occupation: Student

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05200799 Date: 09/14/2012

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05200799 Date: 09/14/2012

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Usual Place of Residence: Address: . . . . . . . . . Village / Town: . . . . . . . . . District: . . . . . . . . . Governorate / State: Shabwa

Identity Card Data: Kind [of Card] . . . . . . Number: . . . . . . . Date of Issue: . . . . . . . Place of Issue: . . . . . . .

Mother's Data: First Name: Father's Name: Grandfather's Name: . . . . . . Surname: . . . . . .

B6

Civil Registry Record: Name of Department: . . . . . . . Number: . . . . . . . Date: . . . . . .

The death was recorded in the Death Registry Book number: 1, under number: 950, on: 11/14/2011 A.D. In the Civil Status Department of the City of: The Main Office

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05200799 Date: 09/14/2012

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05200799 Date: 09/14/2012

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District: [illegible] Governorate: Sanaa

Name of the Registrar: Adnan Mohammed His Signature: [illegible signature]

Name of the Director of the Civil Status Department: Colonel/ Ali Khayran His Signature: [illegible signature]

Seal: [illegible round imprint seal]

CERTIFICATION OF TRANSLATION

I hereby certify that the above translation, bearing LS No. [illegible] was prepared by the Office of Language Services of the U.S. Department of State, and that it is a correct translation to the best of my knowledge and belief.

Dated: [illegible] Chief, Translating Division

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05200799 Date: 09/14/2012

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05191306 Date: 09/14/2012

U.S. Department of State RELEASED IN PART B6 Report of Death of an American Citizen Abroad

12/20/2011 (Post & date of issue) SSA No. [ ] Name in full Abdulrahman Anwar Al-Aulaqi Age 16 Date and Place of Birth 26-Aug-1995 Denver, Colorado United States Of America Evidence of U.S. Citizenship Regular Passport #710207130 Issued On March 04, 2003 Address in U.S.A. Permanent or Temporary Address Abroad Shabwa, Yemen Date of death Oct 14 2011 (Month) (Day) (Hour) (Minute) (Year) Place of death Shabwa Yemen (Number and street) or (Hospital or hotel) (City) (Country) Cause of death Unknown (Including authority for statement - if physician, include full name and official title, if any)

Disposition of the remains Unknown Local law governing disinterment of remains provides that Not Allowed By Local Law Disposition of the effects Unknown Person or official responsible for custody of effects and accounting therefore Unknown Traveling/residing abroad with relatives or friends as follows: NAME ADDRESS N/A N/A Informed by telegram or telephone NAME ADDRESS DATE NOTIFIED 11/30/2011 Copy of this report sent to: NAME ADDRESS DATE SENT 12/24/2011 Notification or copy sent to Federal Agencies: SSA x VA CSC Other (State Agency) The original copy of this document and information concerning the effects are being placed in the permanent files of the Department of State, Washington, D.C. 20520 Remarks: (Continue on reverse if necessary.)

REVIEW AUTHORITY: Sharon Ahmad, Senior Reviewer [SEAL] Stephanie Bunce Consul of the United States of America.

DS-2060 Formerly OF-180 09-2004 For Additional Certified Copies, see http://travel.state.gov/passport/consular_records.html.

UNCLASSIFIED U.S. Department of State Case No. F-2011-25503 Doc No. C05191306 Date: 09/14/2012

B6 Al-Aulaqi (Last name) Abdulrahman (First name) Anwar (Middle name) 14-Oct-2011 (Date of death)