Phone:  1-240.988.4455

Fax :  1-240.206.3227

Email:
travel@usgates.net
Address:
UGI Travel
20407 Cabana Dr. Germantown, MD 20876 - USA

 

Declaration of Conversion to Islam

Date ________________________________

 

This is to certify that ________________________________________ has publicly declared that "Nothing deserves worship except Allah, and prophet Mohammad is his messenger, and therefore is a converted Muslim, and an active member.

 

_____________________________________
Signature of Masjid Imam or Administrator

 

_____________________________________
Male Family member's Signature

_____________________________________
First Witness
UGI Travel
20407 Cabana Dr. Germantown, MD 20876 - USA
* Phone: 240.988.4455 * Fax: 240.206.3227