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---
type: car-purchase-documents
category: vehicle
person: Yanxin Lu, Xuewei Jiang
date: 2023-12-02
source: "2024 LEXUS NX250 DOCUMENTS.pdf"
---
# 2024 Lexus NX 250 Purchase Documents
**Deal #:** 22468
**Customer #:** 1028381
**Stock #:** RC004663
**VIN:** 2T2ADCEZ0RC004663
**Vehicle:** 2024 Lexus NX 250
**Dealership:** Keyes Lexus, 5905 Van Nuys Blvd., Van Nuys, CA 91401
**Buyer:** Yanxin Lu
**Co-Buyer:** Xuewei Jiang
**Address:** 12421 Sanford St, Los Angeles, CA 90066
**Contract Date:** 12/02/2023
---
## 1. Front License Plate Acknowledgement
**Form No.:** LAWCA-FLPRA, e (REV. 6/19)
**Document #:** 083015
**Form Code:** 76428\*1\*VANLEX-FI
| Field | Value |
|---|---|
| Buyer/Lessee Name(s) | YANXIN LU, XUEWEI JIANG |
| Contract Date | 12/02/2023 |
| Address | 12421 SANFORD ST |
| City | LOS ANGELES |
| State | CA |
| Zip | 90066 |
| Year | 2024 |
| Make | LEXUS |
| Model | NX 250 |
| VIN | 2T2ADCEZ0RC004663 |
### Selected Option: VEHICLE IS EQUIPPED WITH A FRONT LICENSE PLATE BRACKET
You have observed and acknowledge that this Vehicle is equipped with a bracket or other means of securing a front license plate, or front temporary license plate, and understand that California law requires a license plate, or temporary license plate, to be displayed from and securely fastened to the front of this Vehicle.
| Field | Value |
|---|---|
| Date | 12/02/2023 |
| Buyer/Lessee Signature | E-SIGNED by YANXIN LU on 2023-12-03 04:08:13 GMT |
| Co-Buyer/Co-Lessee Signature | E-SIGNED by XUEWEI JIANG on 2023-12-03 04:16:42 GMT |
### Non-Selected Option: VEHICLE IS NOT EQUIPPED WITH A FRONT LICENSE PLATE BRACKET AT CUSTOMER'S REQUEST
| Field | Value |
|---|---|
| Date | N/A |
| Buyer/Lessee Signature | N/A |
| Co-Buyer/Co-Lessee Signature | N/A |
---
## 2. Tire Chain Disclosure
**Document #:** 157149
**Deal #:** 22468
**Cust #:** 1028381
**Form No.:** LAWCA-365-eps REV. 4/12, The Reynolds and Reynolds Company
**Form Code:** 35283\*1\*VANLEX-FI
> **AS EQUIPPED, THIS VEHICLE MAY NOT BE OPERATED WITH TIRE CHAINS BUT MAY ACCOMMODATE SOME OTHER TYPE OF TIRE TRACTION DEVICE. SEE THE OWNER'S MANUAL FOR DETAILS.**
The undersigned acknowledges that prior to signing a contract to buy or lease the subject new vehicle, the undersigned read this disclosure and received a signed copy.
| Field | Value |
|---|---|
| Dated | 12/02/2023 |
| Buyer(s) Signature | E-SIGNED by YANXIN LU on 2023-12-03 04:08:35 GMT |
| Co-Buyer(s) Signature | E-SIGNED by XUEWEI JIANG on 2023-12-03 04:16:11 GMT |
---
## 3. Insurance Coverage Acknowledgement
**Dealership:** KEYES LEXUS, 5905 VAN NUYS BLVD., VAN NUYS, CA 91401
**Deal #:** 22468
**Stock #:** RC004663
**Form No.:** LIT-104 (02/14)
**Form Code:** 40676\*1\*VANLEX-FI
**Printed:** 12/02/2023 07:44 pm
| Field | Value |
|---|---|
| Customer Name(s) | YANXIN LU XUEWEI JIANG |
| Date | 12/02/2023 |
| Street Address | 12421 SANFORD ST, LOS ANGELES, CA 90066 |
| Home Telephone | 254/224-1457 |
| Work Telephone | 254/224-1457 |
| Driver's License # | Y5869348 |
| Issuing State | CA |
| Expiration Date | 10/17/2028 |
| Vehicle Year | 2024 |
| Vehicle Make | LEXUS |
| Vehicle Model | NX 250 |
| VIN | 2T2ADCEZ0RC004663 |
I understand that the Retail Installment Sales Contract or Lease Contract ("Finance Contract") that I signed in connection with my purchase/lease of the above-described vehicle requires me to provide and maintain insurance on the vehicle against the risks of loss or damage. I understand that this insurance must be in an amount equal to the lesser of the unpaid amount due under the Finance Contract or the value of the vehicle and must be maintained for the entire term of the Finance Contract. I also understand that the holder of the Finance Contract must be named as the loss payee and that the failure to maintain said insurance coverage may be an event of a default under the Finance Contract. In the event of a default, the holder of the Finance Contract may pursue all of the remedies provided by law and in the Finance Contract as it deems appropriate. Having been advised that I may obtain insurance coverage from a company and agent of my choice, I have selected:
### Insurance Information
| Field | Value |
|---|---|
| Insurance Company | GEICO INS |
| Policy # | 4573971209 |
| Agent's Name | AGENT |
| Telephone | 800/841-3000 |
| Address | PO BOX 509090 SAN DIEGO CA 92150 |
| Insurance Coverage: Collision | [X] $1,000.00 Deductible |
| Insurance Coverage: Comprehensive | [ ] N/A Deductible |
| Policy Effective From | 06/28/2023 |
| Policy Effective To | 12/28/2023 |
| Named Loss Payee | LEXUS FINANCIAL SERVICES |
### Signatures
| Role | Signature | Date |
|---|---|---|
| Customer (Buyer) | E-SIGNED by YANXIN LU on 2023-12-03 04:06:55 GMT | 12/02/2023 |
| Customer (Co-Buyer) | E-SIGNED by XUEWEI JIANG on 2023-12-03 04:17:09 GMT | 12/02/2023 |
| Authorized Dealership Representative | E-SIGNED by Kamroz Davari on 2023-12-03 03:51:12 GMT | 12/02/2023 |
---
## 4. Due Bill
**Document #:** 357736
**Deal #:** 22468
**Cust #:** 1028381
**Form No.:** LAWCA-412-eps (REV. 7/13), The Reynolds and Reynolds Company
**Form Code:** 35303\*1\*VANLEX-FI
### Identification of Parties
| Field | Value |
|---|---|
| Buyer/Lessee Name(s) | YANXIN LU, XUEWEI JIANG |
| Phone | 254-224-1457 |
| Address | 12421 SANFORD ST |
| City | LOS ANGELES |
| State | CA |
| Zip | 90066 |
| Contract Date | 12/02/2023 |
| Dealership | KEYES LEXUS |
| Salesperson | SARKIS KARAPETYAN |
| Sales Manager | Arman Chivichyan |
### Identification of Vehicle
| Year | Make | Model | VIN | Stock Number |
|---|---|---|---|---|
| 2024 | LEXUS | NX 250 | 2T2ADCEZ0RC004663 | RC004663 |
### Section A: Acknowledgment of Work
You acknowledge that the work described in this Section A, if any, is the only work that you are entitled to have performed at no additional charge. If you request any additional work, dealer will provide you with an estimate of charges for your approval prior to performing the additional work.
- A.1. N/A
- A.2. N/A
- A.3. N/A
- A.4. N/A
- A.5. N/A
### Section B: Acknowledgment of Accessories
You acknowledge that the charges for the accessories described in this Section B, if any, were disclosed to you and included in the retail installment sale or lease contract you entered into for the purchase or lease of the Vehicle with your consent. These accessories are the only accessories that you are entitled to have installed at no additional charge. If you request additional accessories, dealer will provide you with an estimate of charges for your approval prior to installation of such accessories.
- B.1. N/A
- B.2. N/A
- B.3. N/A
- B.4. N/A
- B.5. N/A
> PLEASE NOTE THAT LOANER CARS WILL NOT BE AVAILABLE WHILE THE WORK/INSTALLATION IS BEING PERFORMED. PLEASE CONTACT OUR SERVICE DEPARTMENT AS SOON AS POSSIBLE TO SCHEDULE AN APPOINTMENT
### Signatures
| Role | Signature | Date |
|---|---|---|
| Buyer | E-SIGNED by YANXIN LU on 2023-12-03 04:10:08 GMT | 12/02/2023 |
| Co-Buyer | E-SIGNED by XUEWEI JIANG on 2023-12-03 04:17:14 GMT | 12/02/2023 |
| Dealer Representative | E-SIGNED by Kamroz Davari on 2023-12-03 03:51:16 GMT | 12/02/2023 |
---
## 5. Deferred Payment / Down Payment Form
**Stock #:** RC004663
**Deal #:** 22468
**Cust #:** 1028381
**Form No.:** LIT-BS (07/14)
**Form Code:** 40674\*1\*VANLEX-FI
**Printed:** 12/02/2023 07:44 pm
### Electronic Check Service (ECS) Authorization Procedures
1. Date (s) of check (s) must be date of transaction.
2. All Guaranteed Hold Checks must be called in under the Hold Check #, for the total amount of all Hold Checks.
3. Write four-digit approval number on the front of the check (s).
4. All other terms and conditions of the Addendum to the Terms of Service and Procedural Outline for Automated Telephone Authorization (ATA) are incorporated into this agreement.
| Field | Value |
|---|---|
| Dealership Name | KEYES LEXUS |
| Purchase Date | 12/02/2023 |
| Dealer Representative | Kamroz Davari |
| ECS Customer # | (blank) |
| Check Writer Name | (blank) |
| Make and Year | LEXUS |
| Customer Name | YANXIN LU |
| Serial # | 2T2ADCEZ0RC004663 |
### Guaranteed Deferred Payment
| # | Check Number | Dollar Amount | Date To Be Deposited | Approval # |
|---|---|---|---|---|
| 1 | | | | |
| 2 | | | | |
| 3 | | | | |
| 4 | | | | |
| **Total Guaranteed** | | | **NOVA NETWORK** | CALL: 1-800-532-0549 FOR APPROVAL |
### Non Guaranteed Deferred Payment (Lithia Use Only)
| # | Check Number | Dollar Amount | Date To Be Deposited | Source |
|---|---|---|---|---|
| 1 | | | | |
| 2 | | | | |
| 3 | | | | |
| 4 | | | | |
| **Total Non Guaranteed** | | | | |
GM Signature Required For Guaranteed and Non Guaranteed Amounts Over $1,000 X — Date: 12/02/2023
### Lithia (Other Payments)
| # | Payment Type | Dollar Amount | Date To Be Deposited | Source |
|---|---|---|---|---|
| 1 | | | | |
| 2 | | | | |
| 3 | | | | |
| 4 | | | | |
| **Total Other Payment** | | | | |
| **TOTAL DOWN PAYMENT** | | | | |
(If over $10,000 see reverse side of form for 8300 completion)
### Signatures
| Role | Signature | Date |
|---|---|---|
| Dealer Representative | E-SIGNED by Kamroz Davari on 2023-12-03 03:51:28 GMT | 12/02/2023 |
| Customer | E-SIGNED by YANXIN LU on 2023-12-03 04:10:08 GMT | 12/02/2023 |
| Check Writer | (blank) | 12/02/2023 |
8300 Required: **YES / NO**
---
## 6. General Terms and Conditions (Reverse of Deferred Payment Form)
**Form Code:** 40674\*1\*VANLEX-FI
**Printed:** 12/02/2023 07:44 pm
**AUTHORITY TO ACCESS/REVIEW PERSONAL CREDIT HISTORY:** Check Writer specifically authorizes Guarantor to access and review his/her personal credit history to obtain approval for this Agreement and the extension of credit. Check Writer acknowledges that he/she has the right to request in writing within Five (5) days of this Agreement, the nature and scope of the foregoing investigation.
**PROMISE TO PAY:** Check Writer understands that Guarantor may guarantee payment on this Agreement to the ECS Customer. Check Writer acknowledges this Agreement and the services of Guarantor as a material benefit to Check Writer in purchasing said equipment/product and therefore unconditionally promises to pay Guarantor the full payment for any such check listed on this Agreement in the event of default. Check Writer therefore confirms that this Agreement is a personal promissory note whereby Check Writer specifically agrees to abide by the terms of payment and deposit, and that this promissory note shall insure to the benefit of Guarantor for payment in the event of default. Check Writer understands and agrees that Guarantor shall in its sole discretion have the option to proceed directly against the Check Writer for the full value of the check as provided by law.
**DEFAULT:** Check Writer understands and agrees that he/she shall be in default of this Agreement when Guarantor in its sole discretion deems that it has been furnished with any misleading, inaccurate or false information by the Check Writer relating to this transaction, either verbal, or written, or payments due are not made as agreed.
**LEGAL RESPONSIBILITY:** Nothing in this Agreement shall waive or limit Guarantor's legal remedies in the event of default or in the circumstances where Check Writer understands and agrees that jurisdiction and venue in any action a law brought by Guarantor to enforce this Agreement will be in Miami-Dade County, Florida. In addition, Check Writer specifically waives his/her right to a jury trial. Check Writer also agrees to pay Guarantor its court costs, expenses, reasonable attorney's fees and liquidated damages in the amount of fifteen percent (15%) of the total purchase price of the equipment/product when Guarantor is required to use an attorney's services to enforce this Agreement.
### Guarantor Information
EnCircle Inc.
One EnCircle Plaza, 1691 N.W. 107 Avenue, Miami, Florida 33172-2711
Phone (305) 592-7800 - 1-800-827-1100 - Fax (305) 477-6783
www.EnCirclepayments.com
### 8300 Worksheet
8300 - Report Of Cash Payments Of Over $10,000.
Total Vehicle Receivable (Acct. # 21100) $_________ If total is less than $10,000 disregard this section
**LIST CASH & CASH EQUIVALENTS:** Cashier's Checks, Bank Checks/Drafts, Money Orders, Travelers Checks with individual values under $10,000
| Item | Amount |
|---|---|
| CASH - Currency and Coin | $_______ |
| Cashier's Checks | $_______ |
| Money Orders | $_______ |
| Bank Drafts/Checks | $_______ |
| Traveler's Checks | $_______ |
| **TOTAL CASH & EQUIVALENTS** | $_______ |
( ) COMPLETE 8300 FILING IF OVER $10,000
**LIST NON-CASH ITEMS:** Personal Checks, Loan Proceeds, Items with individual value over $10,000
| Item | Amount |
|---|---|
| Personal Checks # ___ # ___ | $_______ |
| Cashier's Checks | $_______ |
| Unsecured Bank Drafts/Checks | $_______ |
| Manufacturer's Rebates | $_______ |
| Credit Cards | $_______ |
| Loan Proceeds | $_______ |
| Funding Source | _______ |
| **TOTAL NON-CASH** | $_______ |
---
## 7. Buyer's eSign Consent Document
ELECTRONIC SIGNATURE CONSENT TO DO BUSINESS Please read this information carefully and retain this information for future reference. Electronic Signatures. You are purchasing a vehicle which requires you to sign a series of forms which may include but are not limited to a buyer's order, a service contract, an insurance form and an odometer statement. This dealership is utilizing electronic signature technology to help make this transaction more convenient and secure. As a result, one or more of the forms required to purchase your vehicle may be eligible for electronic signature execution. Consent. By signing this consent form, you understand and agree that you intend to conduct business electronically and have your signature captured electronically to execute certain forms for this vehicle purchase only. For those forms that are eligible for electronic signature, you acknowledge that by signing your name on the electronic signature pad, you are indicating your intent to sign the applicable forms or documents and this constitutes your signature. for other forms that are not eligible for electronic signature, you will still be required to execute hard copy documents in pen. You will receive copies of all forms signed both electronically and signed in pen. Withdrawal of Consent. You have the right to withdraw your consent to do business electronically at any time during this vehicle purchase transaction. However, if you withdraw such consent during the purchase process, all electronic signatures and consents provided will be considered void and you may elect to proceed with the vehicle purchase using pen and paper signatures for all required documents.
**Signed by:** E-SIGNED by YANXIN LU on 2023-12-03 04:08:51 GMT — **YANXIN LU**
---
## 8. Co-Buyer's eSign Consent Document
ELECTRONIC SIGNATURE CONSENT TO DO BUSINESS Please read this information carefully and retain this information for future reference. Electronic Signatures. You are purchasing a vehicle which requires you to sign a series of forms which may include but are not limited to a buyer's order, a service contract, an insurance form and an odometer statement. This dealership is utilizing electronic signature technology to help make this transaction more convenient and secure. As a result, one or more of the forms required to purchase your vehicle may be eligible for electronic signature execution. Consent. By signing this consent form, you understand and agree that you intend to conduct business electronically and have your signature captured electronically to execute certain forms for this vehicle purchase only. For those forms that are eligible for electronic signature, you acknowledge that by signing your name on the electronic signature pad, you are indicating your intent to sign the applicable forms or documents and this constitutes your signature. for other forms that are not eligible for electronic signature, you will still be required to execute hard copy documents in pen. You will receive copies of all forms signed both electronically and signed in pen. Withdrawal of Consent. You have the right to withdraw your consent to do business electronically at any time during this vehicle purchase transaction. However, if you withdraw such consent during the purchase process, all electronic signatures and consents provided will be considered void and you may elect to proceed with the vehicle purchase using pen and paper signatures for all required documents.
**Signed by:** E-SIGNED by XUEWEI JIANG on 2023-12-03 04:16:35 GMT — **XUEWEI JIANG**
---
## 9. Pre-Contract Disclosure (Retail Installment Sale Contract)
**Cust #:** 1028381
**Deal #:** 22468
**Document #:** 0487299
**Form No.:** LAWCA-PCD 3/23, e (Rev. 3/23), The Reynolds and Reynolds Company
**Form Code:** 103205\*1\*VANLEX-FI
### Identification of Parties
| Field | Value |
|---|---|
| Buyer Name(s) | YANXIN LU, XUEWEI JIANG |
| Contract Date | 12/02/2023 |
| Buyer's Email | Crac1017@gmail.com |
| Address | 12421 SANFORD ST |
| City | LOS ANGELES |
| State | CA |
| Zip | 90066 |
| Buyer's Telephone | 254-224-1457 |
| Dealership | KEYES LEXUS |
### Identification of Vehicle
| Year | Make | Model | VIN |
|---|---|---|---|
| 2024 | LEXUS | NX 250 | 2T2ADCEZ0RC004663 |
### Optional Goods and Services
The following goods and services are NOT required as a condition to obtaining financing terms for the purchase of the Vehicle.
**Optional Theft Deterrent Device(s):** [ ] Not selected
- (1) N/A — $N/A
- (2) N/A — $N/A
- (3) N/A — $N/A
**Optional Surface Protection Product(s):** [ ] Not selected
- (1) N/A — $N/A
- (2) N/A — $N/A
**Optional Service Contract(s):** [ ] Not selected
- (1) N/A — $N/A
- (2) N/A — $N/A
- (3) N/A — $N/A
- (4) N/A — $N/A
- (5) N/A — $N/A
**Optional Debt Cancellation Agreement or Guaranteed Asset Protection Waiver:** N/A — $N/A
**Optional Vehicle Contract Cancellation Option Agreement:** N/A — $N/A
**Optional Insurance Product:** N/A — $N/A
**Total:** $N/A
| Item | Amount |
|---|---|
| Installment Payment EXCLUDING Listed Items | $980.88 |
| Installment Payment INCLUDING Listed Items | $980.88 |
> THE ABOVE INSTALLMENT PAYMENTS INCLUDE THE ITEMS DESCRIBED ABOVE, THE PRICE OF THE VEHICLE, GOVERNMENT FEES AND TAXES, FINANCE CHARGES, AND THE ADDITIONAL CHARGES SHOWN BELOW.
### Other Goods, Services and Miscellaneous Charges
| Item | Amount |
|---|---|
| Cash Price of Additional Accessories | $41,360.89 |
| Other (Nontaxable) | |
| N/A | $N/A |
| N/A | $N/A |
| EV Charging Station | $N/A |
| Electronic Vehicle Registration or Transfer Charge | $33.00 |
| Document Processing Charge | $85.00 |
| Emissions Testing Charge | $N/A |
| Prior Credit or Lease Balance | $ |
| Other (to whom paid) N/A | $N/A |
| For: N/A | |
| Other (to whom paid) N/A | $N/A |
| For: N/A | |
By signing below, you acknowledge:
- All of the charges described above will be included in the retail installment sale contract accompanying the purchase of the Vehicle.
- This document was presented to you prior to signing the retail installment sale contract and you consent to including all the above charges in the retail installment sale contract.
- The goods and services are NOT required as a condition to obtaining financing terms for the purchase of the Vehicle.
| Field | Value |
|---|---|
| Date | 12/02/2023 |
| Buyer's Signature | E-SIGNED by YANXIN LU on 2023-12-03 04:18:51 GMT |
| Co-Buyer's Signature | E-SIGNED by XUEWEI JIANG on 2023-12-03 04:17:30 GMT |
---
## 10. Buyer's Final Signature Document
| Field | Value |
|---|---|
| Deal Number | 22468 |
| Store Name | KEYES LEXUS |
| F&I Manager | Kamroz Davari |
| Date | 12/02/2023 |
| Name | LU YANXIN |
| Role | Buyer |
| Vehicle Make | LEXUS |
| VIN | 2T2ADCEZ0RC004663 |
Please sign below to acknowledge that you have electronically signed the following documents:
1. Buyer's eSign Consent Document
2. CA Front License Plate Ack
3. CA - Tire Chain Disclosure
4. ATPI Lithia
5. CA Due Bill
6. Deferred Payment Form
7. LAW California Pre-Contract Disclosure
**Signed by:** E-SIGNED by YANXIN LU on 2023-12-03 04:16:05 GMT — **YANXIN LU**
**Date:** December 03, 2023
---
## 11. Co-Buyer's Final Signature Document
| Field | Value |
|---|---|
| Deal Number | 22468 |
| Store Name | KEYES LEXUS |
| F&I Manager | Kamroz Davari |
| Date | 12/02/2023 |
| Name | JIANG XUEWEI |
| Role | Co-Buyer |
| Vehicle Make | LEXUS |
| VIN | 2T2ADCEZ0RC004663 |
Please sign below to acknowledge that you have electronically signed the following documents:
1. CA Front License Plate Ack
2. CA - Tire Chain Disclosure
3. ATPI Lithia
4. CA Due Bill
5. Co-Buyer's eSign Consent Document
6. LAW California Pre-Contract Disclosure
**Signed by:** E-SIGNED by XUEWEI JIANG on 2023-12-03 04:17:44 GMT — **XUEWEI JIANG**
**Date:** December 03, 2023
---
## 12. Credit Application
**Date:** 12/2/23, 6:46 PM
**Worksheet**
**Lender Name:** (blank)
**Dealership Name:** Keyes Lexus
### Section 1. Information Regarding Applicant
| Field | Value |
|---|---|
| Last Name (Print) | Lu |
| First | Yanxin |
| Initial | |
| Birth Date | 10/17/1989 |
| Drivers License # | Y5869348 |
| Social Security # | 636-29-3464 |
| Address | 12421 Sanford St |
| City | LOS ANGELES |
| State | CA |
| Zip | 90066 |
| Phone # | (254) 224-1457 |
| How Long: Years/Months | 3 / 0 |
| Billing Address If Different | |
| Email Address | Crac1017@gmail.com |
| Previous Address | |
| Occupation or Rank | |
| Employer | |
| Phone # | () |
| How Long: Years/Months | / |
| Employers Address | |
| Education | |
| Previous Employer | |
| Phone # | () |
| How Long: Years/Months | / |
| Nearest Relative Not living With Me | |
| Phone # | () |
| Relationship | |
| Nearest Relative Not living With Me | |
| Phone # | () |
| Relationship | |
| Applicant's Gross Monthly Income From Employment | $.00 |
| Amount of Additional Monthly Income | $.00 |
| Total Gross Monthly Income | $.00 |
### Section 2. Information Regarding Spouse or Co-Applicant
| Field | Value |
|---|---|
| Last Name (Print) | Jiang |
| First | Xuewei |
| Initial | |
| Birth Date | 03/13/1993 |
| Drivers License # | Y1661483 |
| Social Security # | 092-99-3215 |
| Address | 12421 Sanford St |
| City | LOS ANGELES |
| State | CA |
| Zip | 90066 |
| Phone # | (254) 214-9350 |
| How Long: Years/Months | 3 / 0 |
| Email Address | Crac1017@gmail.com |
| Previous Address | |
| Occupation or Rank | |
| Employer | |
| Phone # | () |
| How Long: Years/Months | / |
| Employers Address | |
| Education | |
| Previous Employer | |
| Phone # | () |
| How Long: Years/Months | / |
| Nearest Relative Not living With Me | |
| Phone # | () |
| Relationship | |
| Nearest Relative Not living With Me | |
| Phone # | () |
| Relationship | |
| Applicant's Gross Monthly Income From Employment | $.00 |
| Amount of Additional Monthly Income | $.00 |
| Total Gross Monthly Income | $.00 |
### Section 3. Assets and Debt Information
| Field | Value |
|---|---|
| Own / Rent / Other | |
| Landlord Or Mortgage Holder | |
| Rent/Mortgage Payment | $.00 |
| City | |
| State | |
| Zip | |
| Phone # | |
| 2nd Rent/Mortgage Payment | $ |
| Type Of Credit | Name Of Company | Name In Which Account Is Carried | Balance | High | Monthly Payments or Date Closed |
|---|---|---|---|---|---|
| | | | $ | $ | $ |
| Field | Value |
|---|---|
| Last Vehicle Purchased (Make, Model, Year) | |
| Financed By | |
| Bank Reference | |
| Address / City / State / Zip | |
| Checking / Savings | |
| Have You Ever Had Any Property Repossessed? | |
| Do you have any Suits Pending Against You | |
| Have You Filed Bankruptcy In The Past 10 Years | |
**Applicant Signature:** X (signed) — Date: 12/2/2023
**Co-Applicant Signature:** X (signed) — Date: 12/2/2023
Co-Applicant's Signature Means Applicant Intends To Apply For Joint Credit.
I Intend To Apply For Joint Credit: Initials: ___
Form: LITHIA_Generic_Credit_App (01/09)
URL: https://lithia.eleadcrm.com/app/desking/pages/Worksheet.aspx?szFileName=Lithia_CreditApp_x3.xslt&lPersonID=232884958&lDealId=235222396 — Page 1/7
---
## 13. Consumer Notice (SB 1398)
### SB 1398, Gonzalez. Vehicles: consumer notices.
Existing law requires any new motor vehicles sold in the state to have certain notices to the consumer either affixed to the vehicle or provided to the buyer.
Existing law requires autonomous vehicles equipped with technology that has the capability to drive a vehicle without the active physical control or monitoring by a human operator. Under existing law, this does not include collision avoidance systems, including, but not limited to, electronic blind spot assistance, automated emergency braking systems, park assist, adaptive cruise control, lane keep assist, lane departure warning, traffic jam and queuing assist, or other similar systems that enhance safety or provide driver assistance, but are not capable, collectively or singularly, of driving the vehicle without the active control or monitoring of a human operator.
This bill would require a dealer or manufacturer that sells any new passenger vehicle that is equipped with a partial driving automation feature, as defined, or that provides any software update or vehicle upgrade that adds a partial driving automation feature, to provide the buyer or owner with a consumer notice that describes the functions and limitations of those features. Any violation of these requirements would be punishable as an infraction.
The bill would additionally prohibit a manufacturer or dealer from deceptively naming or marketing these features, as specified. By creating a new infraction, this bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
*The people of the State of California do enact as follows:*
**SECTION 1.** Section 24011.5 is added to the Vehicle Code, to read:
93
24011.5. (a) A dealer or manufacturer shall not sell any new passenger vehicle that is equipped with any partial driving automation feature, or provide any software update or other vehicle upgrade that adds any partial driving automation feature, without, at the time of delivering or upgrading the vehicle, providing the buyer or owner with a distinct notice that provides the name of the feature and clearly describes the functions and limitations of the feature.
(b) A manufacturer or dealer shall not name any partial driving automation feature, or describe any partial driving automation feature in marketing materials, using language that implies or would otherwise lead a reasonable person to believe, that the feature allows the vehicle to function as an autonomous vehicle, as defined in Section 38750, or otherwise has functionality not actually included in the feature. A violation of this subdivision shall be considered a misleading advertisement for the purposes of Section 11713.
(c) As used in this section, "partial driving automation feature" has the same meaning as "Level 2 partial driving automation" in the Society of Automotive Engineers (SAE) Standard J3016 (April 2021).
(d) Compliance with this section shall not alter any existing duty of care or limit the civil liability of a manufacturer or dealer, including, but not limited to, claims for negligence or product defect.
(e) Before delivering a passenger vehicle equipped with a partial driving automation feature to a dealer, a manufacturer shall provide information to enable the dealer to comply with subdivision (a). This information shall include specific language recommended for the notice required in that subdivision. A dealer may reasonably rely on the information provided by the manufacturer and a dealer shall not be held in violation of subdivision (a) if the manufacturer fails to provide this information to the dealer or if the information provided is deemed to be not in compliance with this section.
(f) A manufacturer shall not be held in violation of subdivision (a) if the manufacturer provides a dealer with the information required under subdivision (e) and the dealer fails to provide the required notice to the buyer or owner.
SEC. 2. No reimbursement is required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIIIB of the California Constitution.
### Signatures
| Role | Print Name | Date |
|---|---|---|
| Buyer: X | Yanxin Lu | 12/1/23 |
| Co-Buyer: X | Xuewei Jiang | 12/1/23 |
---
## 14. Privacy Notice — What Does Keyes Lexus Do With Your Personal Information?
**Rev. January 2011**
**Date:** 12/2/2023, 6:46 PM — Worksheet
### FACTS: WHAT DOES KEYES LEXUS DO WITH YOUR PERSONAL INFORMATION?
**Why?** Financial companies choose how they share your personal information. Federal law gives consumers the right to limit some but not all sharing. Federal law also requires us to tell you how we collect, share and protect your personal information. Please read this notice carefully to understand what we do.
**What?** The types of personal information we collect and share depend on the product or service you have with us. This information can include:
- Social Security number and income
- Credit History and Credit Score
- Account Balances and Employment Information
When you are *no longer* our customer, we continue to share your information as described in this notice.
**How?** All financial companies need to share customer's personal information to run their everyday business. In the section below, we list the reasons financial companies can share their customer's personal information; the reasons Keyes Lexus chooses to share; and whether you can limit this sharing.
| Reasons we can share your personal information | Does Keyes Lexus share? | Can you limit this sharing? |
|---|---|---|
| For our everyday business purposes - such as to process your transactions, maintain your account(s), respond to court orders and legal investigations, or report to credit bureaus | Yes | No |
| For our market purposes to offer our products and services to you | Yes | Yes |
| For joint marketing with other financial companies | No | We Don't Share |
| For our affiliates' everyday business purposes - Information about your transactions and experiences | Yes | No |
| For our affiliates everyday business purposes - Information about your credit worthiness | Yes | No |
| For nonaffiliates to market to you | No | We don't share |
**Questions?** Call **(818) 379-4000**
### Page 2
**Who we are:**
| Question | Answer |
|---|---|
| Who is providing this notice? | Keyes Lexus |
**What we do:**
| Question | Answer |
|---|---|
| How does Keyes Lexus protect my personal information? | To protect your personal information from unauthorized access and use, we use security measures that comply with federal law. These measures include computer safeguards and secured files and buildings. |
| How does Keyes Lexus collect my personal information? | We collect your personal information, for example, when you: Apply for financing or apply for a lease; Pay us by Check or give us your contact information; Show us your drivers license. We also collect your personal information from others, such as credit bureaus. |
| Why can't I limit all sharing? | Federal law gives you the right to limit only: sharing for affiliates everyday business purposes-information about your credit worthiness; affiliates from using your information to market to you; sharing for nonaffiliates to market to you. State laws and individual companies may give you additional rights to limit sharing. |
### Definitions
| Term | Definition |
|---|---|
| Affiliates | Companies related by common ownership or control. They can be financial and nonfinancial companies. *This dealership is owned and/or controlled by Lithia Motors, INC and its affiliated companies* |
| Nonaffiliates | Companies not related by common ownership or control. They can be financial and nonfinancial companies. *Lithia Motors does not share with non-affiliated companies* |
| Joint Marketing | A formal agreement between nonaffiliated financial companies that together market financial products or services to you. *Lithia Motors does not jointly market with non-affiliated companies* |
**Acknowledgment of Receipt:** I hereby acknowledge that I have received a copy of this form from LLC
| Role | Print Name |
|---|---|
| Customer Signature | Yanxin Lu |
| Co-Customer Signature | Xuewei Jiang |
Date: 12/2/2023 18:45 PM
URL: https://lithia.eleadcrm.com/app/desking/pages/Worksheet.aspx?szFileName=Lithia_CreditApp_x3.xslt&lPersonID=232884958&lDealId=235222396 — Page 4/7 & 5/7
---
## 15. Credit Score Disclosure — Yanxin Lu
| Field | Value |
|---|---|
| Customer | Yanxin Lu |
| Address | 12421 Sanford St, Los Angeles, CA, 90066 |
| Phone | 2542241457 |
| Dealership | KEYES LEXUS OF VAN NUYS |
| Dealership Address | 5905 VAN NUYS BLVD, VAN NUYS, CA, 91401-5618 |
| Dealership Phone | 8185382990 |
### Your Credit Score
| | Source 1 | Source 2 | Source 3 |
|---|---|---|---|
| Score | **853** | Not Run | Not Run |
| Source | Experian | TransUnion | Equifax |
| Model | FICO AUTO V8 | Not Run | Not Run |
| Date | 2023-12-02 22:25:11 | Not Run | Not Run |
### Understanding Your Credit Score
| Topic | Details |
|---|---|
| What you should know about credit scores | Your credit score is a number that reflects the information in your credit report. Your Credit report is a record of your credit history. It includes information about whether you pay your bills on time and how much you owe to creditors. Your credit score can change, depending on how your credit history changes. |
| How we use your credit score | Your credit score can affect whether you can get a loan and how much you will have to pay for that loan. |
| The range of scores | Scores range from a low of 250 to a high of 900. Generally, the higher your score, the more likely you are to be offered better credit terms. |
### How Your Score Compares (Experian)
| Score Range | % of consumers |
|---|---|
| 250-350 | 0.0 |
| 351-500 | 7.0 |
| 501-600 | 23.1 |
| 601-700 | 31.9 |
| 701-800 | 26.7 |
| 801-900 | 11.2 |
### Checking Your Credit Report
| Topic | Details |
|---|---|
| What if there are mistakes in your credit report? | You have a right to dispute any inaccurate information in your credit report. If you find mistakes on your credit report, contact the consumer reporting agency. It is a good idea to check your credit report to make sure the information it contains is accurate. |
| How can you obtain a copy of your credit report? | Under federal law, you have the right to obtain a free copy of your credit report from each of the nationwide consumer reporting agencies once a year. To order your free annual credit report --. By telephone: Call toll-free: 1-877-322-8228. On the web: Visit: www.annualcreditreport.com. By mail: Mail your completed Annual Credit Report Request Form to: Annual Credit Report Request Service, P.O. Box 105281, Atlanta, GA 30348-5281 |
| How can you get more information? | For more information about credit reports and your rights under federal law, visit Federal Reserve Board's web site at www.federalreserve.gov or the Federal Trade Commission's web site at www.ftc.gov or the Consumer Financial Protection Bureau's web site at www.consumerfinance.gov/learnmore. |
**Signed by:** X — Yanxin Lu
---
## 16. Credit Score Disclosure — Xuewei Jiang
| Field | Value |
|---|---|
| Customer | Xuewei Jiang |
| Address | 12421 Sanford St, Los Angeles, CA, 90066 |
| Phone | 2542149350 |
| Dealership | KEYES LEXUS OF VAN NUYS |
| Dealership Address | 5905 VAN NUYS BLVD, VAN NUYS, CA, 91401-5618 |
| Dealership Phone | 8185382990 |
### Your Credit Score
| | Source 1 | Source 2 | Source 3 |
|---|---|---|---|
| Score | **855** | Not Run | Not Run |
| Source | Experian | TransUnion | Equifax |
| Model | FICO AUTO V8 | Not Run | Not Run |
| Date | 2023-12-02 22:26:05 | Not Run | Not Run |
### Understanding Your Credit Score
(Same content as Yanxin Lu's credit score disclosure above.)
### How Your Score Compares (Experian)
| Score Range | % of consumers |
|---|---|
| 250-350 | 0.0 |
| 351-500 | 7.0 |
| 501-600 | 23.1 |
| 601-700 | 31.9 |
| 701-800 | 26.7 |
| 801-900 | 11.2 |
**Signed by:** X — Xuewei Jiang
---
## 17. Thumbprint Form — Yanxin Lu
**Document #:** 315140
**Deal #:** 22468
**Stock #:** RC004663
**Cust #:** 1028381
**Form No.:** LAWCA-TP-eps (REV. 4/12), The Reynolds and Reynolds Company
**Form Code:** 50161\*1\*VANLEX-FI
| Field | Value |
|---|---|
| Buyer/Lessee Name | YANXIN LU |
| Today's Date | 12/02/2023 |
| Address | 12421 SANFORD ST |
| City | LOS ANGELES |
| State | CA |
| Zip | 90066 |
| Year | 2024 |
| Make | LEXUS |
| Model | NX 250 |
| VIN | 2T2ADCEZ0RC004663 |
As part of this dealership's commitment to preventing identity theft, it is our policy to request a thumbprint of each customer who is purchasing a vehicle on credit or leasing a vehicle.
The box to the right contains the buyer/lessee's:
- [X] Right thumbprint
- [ ] Other print (specify) ___
**Print taken by:** Kamroz Davari (Dealer Representative)
**Buyer/Lessee Signature:** (signed)
---
## 18. Thumbprint Form — Xuewei Jiang
**Document #:** 315139
**Deal #:** 22468
**Stock #:** RC004663
**Cust #:** 1028381
**Form No.:** LAWCA-TP-eps (REV. 4/12), The Reynolds and Reynolds Company
**Form Code:** 50161\*1\*VANLEX-FI
| Field | Value |
|---|---|
| Buyer/Lessee Name | YANXIN LU / XUEWEI JIANG |
| Today's Date | 12/02/2023 |
| Address | 12421 SANFORD ST |
| City | LOS ANGELES |
| State | CA |
| Zip | 90066 |
| Year | 2024 |
| Make | LEXUS |
| Model | NX 250 |
| VIN | 2T2ADCEZ0RC004663 |
As part of this dealership's commitment to preventing identity theft, it is our policy to request a thumbprint of each customer who is purchasing a vehicle on credit or leasing a vehicle.
The box to the right contains the buyer/lessee's:
- [X] Right thumbprint
- [ ] Other print (specify) ___
**Print taken by:** Kamroz Davari (Dealer Representative)
**Buyer/Lessee Signature:** (signed)
---
## 19. Handwritten Notes (F&I Product Offers)
Handwritten notes from F&I office showing product offers and pricing:
### GAP (Guaranteed Asset Protection)
(crossed out / declined)
### VSA (Vehicle Service Agreement)
- 8/75 — $3,995
- +4: 8/100 (crossed out)
- 4/50
- +6: 10/100 — $5,495
- 10/75 (crossed out)
- **Declined** (Nox signature with initials)
### TW-72 (Tire & Wheel Protection, 72 months)
- $2,895
- **Declined** (Nox signature with initials)
### PPM (Pre-Paid Maintenance)
- 5 years / 50K miles = $3,981
- (note: $398 per service)
- Total 10 Services
- Every 6 months or 5K miles
- **Declined** (Nox signature with initials)

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---
type: insurance
category: auto insurance
person: Yanxin Lu, Xuewei Jiang
date: 2021-06-28
source: insurance.pdf
---
# GEICO Insurance Policy - Cover Letter & ID Cards
## Cover Letter
**Policy Number:** 4573-97-12-09
**Policyholder:**
YANXIN LU AND XUEWEI JIANG
11950 IDAHO AVE APT 113
LOS ANGELES CA 90025-5794
**Active Drivers:**
- YANXIN LU
- XUEWEI JIANG
Dear Policyholder,
Policy Identification Cards (Insurance ID Cards) have been provided for each insured vehicle.
**Any driver covered on your policy can present the attached ID Cards as valid proof of insurance. You do not need a separate ID Card for each driver.** For your convenience, we have listed all Active Drivers on this policy below.
This letter is for informational purposes only and is not official proof of insurance. Please notify us promptly of any changes in your address to be sure you receive all important policy documents. Prompt notification will enable us to better serve you. If you need additional ID Cards for a new vehicle, vehicle registration or just another card for your records, you can log into the GEICO Mobile app or visit geico.com.
IDCOVLTR (08-19)
---
## Evidence of Insurance - Instructions
Here are your Evidence of Liability Insurance Cards. Two cards have been provided for each vehicle insured. One card must be carried in the proper insured vehicle. Proof of insurance is required to register or renew the registration of your vehicle. A law enforcement officer can ask you to prove that you have liability insurance meeting the basic requirements of California law.
A violation of these requirements can result in a fine of up to:
- $1,000 for the first time
- $2,000 for additional times
Also, a judge can have your vehicle impounded. False proof of insurance may result in a fine up to $750 and 30 days in prison.
Due to space limitations on the ID card, only the Named Insured and the Co-insured are listed. For a full list of drivers covered under this policy, please reference the Drivers section of your Declarations Page, which is included with your insurance packet.
If you would like additional ID cards you can go online to geico.com or call us at 1-800-841-3000.
---
## California Evidence of Liability Insurance Card
| Field | Details |
|---|---|
| **Insurer** | GEICO GENERAL INSURANCE COMPANY |
| **Address** | P.O. Box 509090, San Diego, CA 92150-9090 |
| **Phone** | 1-800-841-3000 |
| **NAIC Code** | 35882 |
| **Policy Number** | 4573-97-12-09 |
| **Effective Date** | 06-28-21 |
| **Expiration Date** | 12-28-21 |
### Vehicle Information
| Year | Make | Model | Vehicle ID No. |
|---|---|---|---|
| 2016 | HONDA | CIVIC | 19XFC2F7XGE093564 |
### Insured
Yanxin Lu
Xuewei Jiang
11950 Idaho Ave Apt 113
Los Angeles CA 90025-5794
The coverage provided by this policy meets the minimum requirements of sections 16056 & 16500.5 of the California Vehicle Code, minimum liability limits prescribed by the law.
---
## What To Do at the Time of an Accident
- Do not admit fault.
- Do not reveal the limits of your liability coverage to anyone.
- Exchange contact information; get year, make, model, plate number, insurance carrier and policy number of all involved. Also, identify witnesses and collect contact information.
- Contact the police or 911 if applicable.
- Contact GEICO by calling **1-800-841-3000** or visit **geico.com** to report the accident.
**Need a tow or roadside assistance?**
Call **1-800-424-3426** to reach GEICO's **Emergency Road Service (ERS)**.
U-4-CA (11-09)

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---
type: dmv form
category: title/registration application
person: Xuewei Jiang
date: 2021-07-29
source: title_application.pdf
---
# Application for Title or Registration (REG 343)
**Form:** REG 343 (REV. 4/2021) WWW
**Agency:** State of California, Department of Motor Vehicles - A Public Service Agency
---
## Section 1 -- Vehicle Information
| Field | Value |
|---|---|
| **Vehicle Identification Number** | 19XFC2F7XGE093564 |
| **Vehicle Make** | Honda |
| **Year Model** | 2016 |
| **Fuel Type** | Gas |
| **California License Number** | *(blank)* |
| **Model or Series** | Civic |
| **Body Type Model** | EX |
| **Motorcycle Engine Number** | *(blank)* |
**Type of Vehicle:** [X] Auto (includes truck or pickup)
**For Trailer Coaches Only:** *(not applicable)*
- Will this vehicle be used for the transportation of persons for hire, compensation, or profit? **No** [X]
- Is this a commercial vehicle that operates at 10,001 lbs. or more? **No** [X]
**For Commercial Vehicles Only:** *(not applicable)*
---
## Section 2 -- Owner Information
| Field | Value |
|---|---|
| **True Full Name of Owner** | *(blank)* |
| **Driver License/ID Card Number** | *(blank)* |
| **Co-Owner/Lessee** | *(blank)* |
| **Physical Residence or Business Address** | 11950 Idaho Ave. |
| **Apt./Space/Ste. No.** | Apt. 113 |
| **City** | *(blank)* |
| **State** | CA |
| **Zip Code** | 90025 |
| **County of Residence** | Los Angeles |
| **Equipment Number** | *(blank)* |
| **Mailing Address** | *(blank)* |
| **Lessee Address** | *(blank)* |
---
## Section 3 -- Legal Owner (Lien Holder/Title Holder)
**True Full Name of Bank/Finance Company or Individual:** None
---
## Section 4 -- Odometer Information
- [X] As of this date is (if no change in ownership): **28,579** miles
- Odometer reading reflects the **ACTUAL** mileage
- No odometer discrepancy noted
---
## Section 5 -- Date Information
| Field | Value |
|---|---|
| **Date Vehicle Entered or Will Enter California** | Month: 11, Day: 21, Year: 2020 |
| **Date Vehicle First Operated in California** | *(blank)* |
| **Date You Went to Work in CA / Obtained CA DL / Became a Resident** | *(blank)* |
| **Date Vehicle Was Purchased or Acquired** | Month: 10, Day: 23, Year: 2016 |
| **Condition** | [X] New |
| **Purchased** | [X] Outside CA |
---
## Section 6 -- Cost Information
- [X] **PURCHASE** -- I purchased the vehicle for the price of $ *(amount blank)*
**Vehicle Was Purchased or Acquired From:**
- [X] Dealer
**Body type modifications made?** *(not checked -- implied No)*
---
## Section 7 -- For Out-of-State or Out-of-Country Vehicles
- Sales Tax paid to another state? [X] **N/A**
- Disposition of Out-of-State Plates: [X] **Expired**, or will be or were
---
## Section 8 -- Military Service Information
- Are you or your spouse on active duty as a member of the U.S. Uniformed Services? **No** [X]
- When this vehicle was last licensed, were you or your spouse on active duty? **No** [X]
---
## Section 9 -- Certifications
*I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.*
| Field | Value |
|---|---|
| **Printed Name** | Xuewei Jiang |
| **Owner's Signature** | X *(signed)* |
| **Date** | 07/29/2021 |
| **Daytime Telephone Number** | (254) 214-9350 |
| **Co-Owner** | *(blank)* |

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---
type: dmv confirmation
category: REAL ID application
person: Xuewei Jiang
date: 2021-07-26
source: dmv_code_2.pdf
---
# DMV Document Verification - REAL ID Confirmation Code
**Page Title:** Document Verification | REAL ID | California DMV
**URL:** https://www.radv.dmv.ca.gov/dv/saved
**Date:** 7/26/2021
## Session Saved
**Your session has been successfully saved**
An email with a link to resume your session has been sent to:
**xueweijiang0313@gmail.com**
## Ready to submit your documents to complete your REAL ID application?
**Need to go to the DMV before you have finished uploading your documents?**
Present the confirmation code below upon arrival at a DMV field office.
**This is your confirmation code:**
## 787E-E11E
Show it to a DMV employee

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---
type: utility bill
category: internet bill
person: Yanxin Lu
date: 2020-11-23
source: internet_bill.pdf
---
# Spectrum Internet Bill - November 23, 2020
**Provider:** Spectrum
**Pages:** 6
**Note:** First bill -- "Welcome to Spectrum!"
## Account Information
| Field | Value |
|---|---|
| **Date** | November 23, 2020 |
| **Account Number** | 8448 20 019 3405122 |
| **Security Code** | 4572 |
| **Account Holder** | YANXIN LU |
| **Service Address** | 11950 IDAHO AVE APT 113, LOS ANGELES CA 90025-5794 |
## Page 1 - Welcome to Spectrum
Welcome letter with instructions to set up account at Spectrum.net:
1. **Select Menu** - It's located in the upper left-hand corner of the Spectrum.net homepage.
2. **Click Contact Info** - Enter the primary phone number or email address associated with your account.
3. **Choose a Username** - You can either use your email address or phone number, or create a custom username.
4. **Create a Password** - Choose a password that you can remember, then set up your security question.
**Get America's #1 Rated Support App** - The My Spectrum App is the easiest way to manage your account.
Visit **Spectrum.net/welcome** to learn more.
*Based on all national telecommunications providers with at least 150,000 reviews in the Apple App Store and Google Play Store as of 12/1/2019 and operating in at least 20 states. (c) 2020 Charter Communications.*
**Spectrum Corporate Address:** 4145 S. FALKENBURG RD RIVERVIEW FL 33578-8652
## Summary
**Service Period:** 11/23/20 through 12/22/20
| Item | Amount |
|---|---|
| Previous Balance | $0.00 |
| Payments Received | $0.00 |
| **Remaining Balance** | **$0.00** |
| Internet Services | $69.99 |
| One-Time Charges | $9.99 |
| **Current Charges** | **$79.98** |
| **Total Due by 12/10/20** | **$79.98** |
**Welcome to Spectrum!** This bill reflects install & service charges from the date of install through your current billing period. If you made a payment at time of install, this bill may not reflect that payment but your next bill will.
## Spectrum News
- **Important Billing Update:** Effective with your next billing statement, monthly pricing will change as follows:
- Internet Service will increase by $5.00.
- If you are currently on a promotion, the increase may not become effective until the end of your promotion period.
## Charge Details
| Item | Amount |
|---|---|
| Previous Balance | $0.00 |
| **Remaining Balance** | **$0.00** |
Payments received after 11/23/20 will appear on your next bill.
### Internet Services (11/23/20 through 12/22/20)
| Service | Amount |
|---|---|
| Spectrum Internet Ultra | $20.00 |
| Spectrum Internet | $69.99 |
| Internet $49.99 12m (promotional discount) | -$20.00 |
| | **$69.99** |
| Internet Services Total | $69.99 |
### One-Time Charges
| Charge | Date | Amount |
|---|---|---|
| Self-install Activation Charge | 11/23 | $9.99 |
| One-Time Charges Total | | $9.99 |
| | Amount |
|---|---|
| **Current Charges** | **$79.98** |
| **Total Due by 12/10/20** | **$79.98** |
## Payment Information
**Please Remit Payment To:**
SPECTRUM
PO BOX 60074
CITY OF INDUSTRY CA 91716-0074
## Billing Information
- **Tax and Fees:** This statement reflects the current taxes and fees for your area (including sales, excise, user taxes, etc.). These taxes and fees may change without notice.
- **Terms & Conditions:** Spectrum's detailed standard terms and conditions for service are located at spectrum.com/policies.
- **Spectrum Terms and Conditions of Service:** Spectrum services are billed on a monthly basis. Spectrum does not provide credits for monthly subscription services that are cancelled prior to the end of the current billing month.
- **Alternate Statement Formats:** Contact Spectrum at 1-844-762-1301.
- **Past Due Fee / Late Fee Reminder:** A late fee will be assessed for past due charges for service.
- **Complaint Procedures:** You have 60 days from the billing date to register a complaint if you disagree with your charges.
## Page 2 - Your Guide to Spectrum
- **Stay safe online** - Security Suite for FREE. Visit Spectrum.net/securitycenter.
- **Don't have WiFi?** - Add fast in-home WiFi for just $5 more a month. Call 1-855-880-4758.
- **Set up your Spectrum email account** - Sign in to your account online. Up to six additional email accounts.
- **Add Spectrum TV** - FREE HD and FREE On Demand. Visit Spectrum.com/TV
- **Add home phone service** for $9.99 per month with unlimited nationwide calling. Visit Spectrum.com/phone
- **Switch to Spectrum Mobile** and save up to 40% on your wireless bill. Visit SpectrumMobile.com/savingscalculator
- Or call **1-855-880-4758** to save with Spectrum
## Local Store
Local Spectrum Store: 328 Santa Monica Blvd, Santa Monica CA 90401
Store Hours: Mon thru Sat - 10:00am to 8:00pm; Sun - 12:00pm to 5:00pm
## Contact Information
- Website: Spectrum.net/billing
- Phone: 1-855-70-SPECTRUM (1-855-707-7328)
- Support: Spectrum.net/support
- Stores: Spectrum.com/stores
- Go Paperless: spectrum.net/paperless
## Payment Options
- **Pay Online** - Sign in to Spectrum.net to pay or view your bill.
- **Pay by Mail** - Detach payment coupon and enclose with your check made payable to Spectrum.

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---
type: utility bill
category: internet bill
person: Yanxin Lu
date: 2021-07-23
source: internet_bill_2.pdf
---
# Spectrum Internet Bill - July 23, 2021
**Provider:** Spectrum
**Document Type:** Auto Pay Notice
**Pages:** 6
## Account Information
| Field | Value |
|---|---|
| **Date** | July 23, 2021 |
| **Account Number** | 8448 20 019 3405122 |
| **Security Code** | 4572 |
| **Account Holder** | YANXIN LU |
| **Service Address** | 11950 IDAHO AVE APT 113, LOS ANGELES CA 90025-5794 |
| **Mailing Address** | 11950 IDAHO AVE APT 113, LOS ANGELES CA 90025-5794 |
## Summary
**Service Period:** 07/23/21 through 08/22/21
| Item | Amount |
|---|---|
| Previous Balance | $69.99 |
| Payments Received - Thank You! | -$69.99 |
| **Remaining Balance** | **$0.00** |
| Internet Services | $69.99 |
| **Current Charges** | **$69.99** |
**YOUR AUTO PAY WILL BE PROCESSED 08/10/21**
**Total Due by Auto Pay: $69.99**
## Charge Details
| Item | Date | Amount |
|---|---|---|
| Previous Balance | | $69.99 |
| Credit Card Payment | 07/11 | -$69.99 |
| **Remaining Balance** | | **$0.00** |
Payments received after 07/23/21 will appear on your next bill.
## Internet Services (07/23/21 through 08/22/21)
| Service | Amount |
|---|---|
| Spectrum Internet Ultra | $20.00 |
| Spectrum Internet | $74.99 |
| Internet $49.99 12m (promotional discount) | -$25.00 |
| | **$69.99** |
*Your promotional price will expire on 11/22/21*
| | Amount |
|---|---|
| Internet Services Total | $69.99 |
| **Current Charges** | **$69.99** |
| **Total Due by Auto Pay** | **$69.99** |
## Spectrum Mailing Address
SPECTRUM
PO BOX 60074
CITY OF INDUSTRY CA 91716-0074
**Spectrum Corporate Address:** 4145 S. FALKENBURG RD RIVERVIEW FL 33578-8652
## Billing Information
- **Tax and Fees:** This statement reflects the current taxes and fees for your area (including sales, excise, user taxes, etc.). These taxes and fees may change without notice.
- **Terms & Conditions:** Spectrum's detailed standard terms and conditions for service are located at spectrum.com/policies.
- **Spectrum Terms and Conditions of Service:** Spectrum services are billed on a monthly basis. Spectrum does not provide credits for monthly subscription services that are cancelled prior to the end of the current billing month.
- **Alternate Statement Formats:** Alternative formats of Spanish, Spanish or English Braille and Spanish or English large print are available. Contact Spectrum at 1-844-762-1301.
- **Past Due Fee / Late Fee Reminder:** A late fee will be assessed for past due charges for service.
- **Franchise Administrator:** City of Los Angeles, Information Technology Agency, 200 N Main St, City Hall East, 14th Floor, Los Angeles CA 90012. Telephone and TDD: 3-1-1 One Call To City Hall or http://www.lacity.org
- **Complaint Procedures:** You have 60 days from the billing date to register a complaint if you disagree with your charges.
## Local Store
Local Spectrum Store: 328 Santa Monica Blvd, Santa Monica CA 90401
Store Hours: Mon thru Sat - 10:00am to 8:00pm; Sun - 12:00pm to 5:00pm
## Contact Information
- Website: Spectrum.net/billing
- Phone: 1-855-70-SPECTRUM (1-855-707-7328)
- Moving: 1-855-230-1324 or Spectrum.net/easymove
- Support: Spectrum.net/support
- Stores: Spectrum.com/stores
## Privacy Notice Reference
Pages 3-6 contain the Spectrum 2021 Annual Privacy Notice (effective June 1, 2021), addressing data collection, use, sharing, and subscriber rights under federal law.
**Privacy Contact:**
Charter Communications, Inc.
Attn: Privacy and Cybersecurity Counsel
400 Atlantic Street, 9th Floor
Stamford, CT 06901

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---
type: immigration document
category: H1B approval notice
person: Xuewei Jiang
date: 2020-10-07
source: jiang-i797-h1b-2020.pdf
---
# I-797A Notice of Action - H1B Approval
**Form:** I-797A | NOTICE OF ACTION
**Issuing Agency:** Department of Homeland Security, U.S. Citizenship and Immigration Services
**Form Version:** FORM I-797A [REV. 08/01/16]
## Page 1 of 2
### Case Information
| Field | Value |
|---|---|
| **Receipt Number** | WAC2032850724 |
| **Case Type** | I129 - PETITION FOR A NONIMMIGRANT WORKER |
| **Received Date** | 09/30/2020 |
| **Priority Date** | *(blank)* |
| **Petitioner** | UNIVERSITY OF SOUTHERN CALIFORNIA |
| **Notice Date** | 10/07/2020 |
| **Page** | 1 of 2 |
| **Beneficiary** | A116 564 749 |
| **Beneficiary Name** | JIANG, XUEWEI |
### Petitioner Address
UNIVERSITY OF SOUTHERN CALIFORNIA
c/o JOSEPH I ELIAS ESQ DIR FACULTY/STA
3434 SOUTH GRAND AVE STE CAL 302
LOS ANGELES CA 900892812
### Approval Details
| Field | Value |
|---|---|
| **Notice Type** | Approval Notice |
| **Class** | H1B |
| **Valid from** | 10/16/2020 to 10/15/2023 |
### Notice Text
The above petition and accompanying request for a change of status have been approved. The status of the named beneficiary(ies) in this classification is valid as indicated on the I-94 attached below. The beneficiary(ies) can work for the petitioner pursuant to this approval notice, but only as detailed in the petition and during the petition validity period indicated above, unless otherwise authorized by law. Changes in employment or training may require you to file a new Form I-129, Petition for a Nonimmigrant Worker.
The dates in the I-94 attached below might not be for the same dates as the petition validity dates above because the I-94 below may contain a grace period of up to 10 days before and up to 10 days after the petition validity period for the following classifications: CW-1, E-1, E-2, E-3, H-1B, H-2B, H-3, L-1A, L-1B, O-1, O-2, P-1, P-1S, P-2, P-2S, P-3, P-3S, TN-1, and TN-2. An I-94 for H-2A nonimmigrants may contain a grace period of up to one week before and 30 days after the petition validity period. However, the beneficiary(ies) may not work during such grace periods, unless otherwise authorized by law. The decision to grant a grace period and the length of the granted grace period is discretionary, final, and cannot be contested on motion or appeal. Please contact the IRS with any questions about tax withholding.
The petitioner should keep the upper portion of this notice. The lower portion should be given to the beneficiary(ies). The beneficiary(ies) should keep the right part (the I-94 portion) with his or her other Forms I-94, Arrival-Departure Record. The I-94 portion should be given to the U.S. Customs and Border Protection when he or she leaves the United States. The left part is for his or her records. A person granted a change of status who leaves the U.S. and is not visa-exempt must normally obtain a visa in the new classification before returning. The left part can be used when applying for the new visa. If a visa is not required, he or she should present it, along with any other required documentation, when applying for reentry based on this approval notice at a port of entry or pre-flight inspection station. The petitioner may also file Form I-824, Application for Action on an Approved Application or Petition, to request that we notify a consulate, port of entry, or pre-flight inspection office of this approval.
The approval of this petition does not guarantee that the beneficiary(ies) will be found to be eligible for a visa, for admission to the United States (if traveling abroad and seeking re-admission), or for a subsequent extension of stay, change of status, or adjustment of status.
**THIS FORM IS NOT A VISA AND MAY NOT BE USED IN PLACE OF A VISA.**
### USCIS Office
California Service Center
U.S. CITIZENSHIP & IMMIGRATION SVC
P.O. Box 30111
Laguna Niguel CA 92607-0111
**USCIS Contact Center:** www.uscis.gov/contactcenter
### Detach Section - Personal Records (Left)
| Field | Value |
|---|---|
| **Receipt#** | WAC2032850724 |
| **I-94#** | 490459797 A2 |
| **NAME** | JIANG, XUEWEI |
| **CLASS** | H1B |
| **VALID FROM** | 10/16/2020 |
| **UNTIL** | 10/25/2023 |
**PETITIONER:**
UNIVERSITY OF SOUTHERN CALIFORNIA,
3434 SOUTH GRAND AVE STE CAL 302
LOS ANGELES CA 900892812
### Detach Section - I-94 Departure Record (Right)
| Field | Value |
|---|---|
| **I-94#** | 490459797 A2 |
| **Receipt Number** | WAC2032850724 |
| **Issuer** | US Citizenship and Immigration Services |
**I94 Departure Record**
**Petitioner:** UNIVERSITY OF SOUTHERN CALIFORNIA
| Field | Value |
|---|---|
| **14. Family Name** | JIANG |
| **15. First (Given) Name** | XUEWEI |
| **16. Date of Birth** | 03/13/1993 |
| **17. Country of Citizenship** | CHINA, PEOPLE'S REPUBLIC OF |
---
## Page 2 of 2
### Case Information (Repeated Header)
| Field | Value |
|---|---|
| **Receipt Number** | WAC2032850724 |
| **Case Type** | I129 - PETITION FOR A NONIMMIGRANT WORKER |
| **Received Date** | 09/30/2020 |
| **Notice Date** | 10/07/2020 |
| **Page** | 2 of 2 |
| **Petitioner** | UNIVERSITY OF SOUTHERN CALIFORNIA, |
| **Beneficiary** | A116 564 749 |
| **Beneficiary Name** | JIANG, XUEWEI |
### Small Business Notice
The Small Business Regulatory Enforcement and Fairness Act established the Office of the National Ombudsman (ONO) at the Small Business Administration. The ONO assists small businesses with issues related to federal regulations. If you are a small business with a comment or complaint about regulatory enforcement, you may contact the ONO at www.sba.gov/ombudsman or phone 202-205-2417 or fax 202-481-5719.
### Verification Notice
**NOTICE:** Although this application or petition has been approved, USCIS and the U.S. Department of Homeland Security reserve the right to verify this information before and/or after making a decision on your case so we can ensure that you have complied with applicable laws, rules, regulations, and other legal authorities. We may review public information and records, contact others by mail, the internet or phone, conduct site inspections of businesses and residences, or use other methods of verification. We will use the information obtained to determine whether you are eligible for the benefit you seek. If we find any derogatory information, we will follow the law in determining whether to provide you (and the legal representative listed on your Form G-28, if you submitted one) an opportunity to address that information before we make a formal decision on your case or start proceedings.
### USCIS Office (Page 2)
California Service Center
U.S. CITIZENSHIP & IMMIGRATION SVC
P.O. Box 30111
Laguna Niguel CA 92607-0111
**Customer Service Telephone:** 800-375-5283
### Detach Section (Page 2)
All fields marked: **INTENTIONALLY LEFT BLANK**

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---
type: passport
category: identity document
person: Xuewei Jiang
date: 2011-04-04
source: jiang-passport.pdf
---
# Chinese Passport - Jiang Xuewei (Old)
**Country:** People's Republic of China (中华人民共和国)
**Document:** Passport (护照)
## Passport Information (Page 1)
| Field | Value |
|---|---|
| **Type (类型)** | P |
| **Country Code (国家码)** | CHN |
| **Passport No. (护照号)** | G49056249 |
| **Surname (姓)** | 姜 / JIANG |
| **Given Names (名)** | 薛伟 / XUEWEI |
| **Sex (性别)** | 女 / F |
| **Date of Birth (出生日期)** | 13 MAR 1993 |
| **Place of Birth (出生地点)** | 山东 / SHANDONG |
| **Date of Issue (签发日期)** | 04 MAR 2011 |
| **Date of Expiry (有效期至)** | 03 MAR 2021 |
| **Authority (签发机关)** | 公安部出入境管理局 / Exit & Entry Administration, Ministry of Public Security |
| **Serial Number** | L1ZZ88L9 |
### Machine Readable Zone (MRZ)
```
POCHNJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<<<
G49056249CCHN9303139F2103031192O3701<<<<<<<52
```
## Observations Pages (Pages 2-3)
Pages 2-3: 备注 Observations -- blank, no entries.
Passport number G49056249 printed at bottom of page 2.
## Page 3 (Pages 8-9 of passport) - Schengen Visa & China Stamps
### Schengen Visa
| Field | Value |
|---|---|
| **Type** | C |
| **Valid From** | 12-08-17 |
| **Valid Until** | 03-08-17 *(likely 03-08-18)* |
| **Place of Issue** | NEW YORK |
| **Entries** | 01 |
| **Passport Number** | G49056249 |
| **Issue Date** | 02-09-17 |
| **Number** | 00214932S |
| **Surname** | JIANG |
| **Given Name** | XUEWEI |
| **MRZ Line 1** | VCNORJIANG<<XUEWEI<<<<<<<<<<<<<<< |
| **MRZ Line 2** | 00214935252CHN9303139F1709023<10708l2 |
### Entry/Exit Stamps on Page 8-9
| Stamp | Date | Location | Type |
|---|---|---|---|
| KEFLAVIKURFLUGVOLLUR F046 (Iceland) | 18.08.17 | Keflavik | Entry (arrow up) |
| 中国边检 CHINA | 2018-06-04 | 北京 (出) Beijing (Exit) | Exit, No. 1083 |
| KEFLAVIKURFLUGVOLLUR F078 (Iceland) | 12.08.17 *(likely 2017)* | Keflavik | Exit (arrow down) |
## Page 4 (Pages 24-25) - Hong Kong & China Stamps
### Entry/Exit Stamps
| Stamp | Date | Location | Type |
|---|---|---|---|
| HONG KONG IMMIGRATION | 12 AUG 2012 | Hong Kong | Entry -- VISITOR, permitted to remain for 7 days |
| HONG KONG | 13 AUG 2012 | Hong Kong | *(stamp)* |
| HONG KONG IMMIGRATION | 23 MAY 2012 | Hong Kong | Entry -- VISITOR, permitted to remain for 7 days |
| HONG KONG IMMIGRATION DEPARTURE | 23 MAY 2012 | Hong Kong | Departure |
| 中国边检 CHINA | 2013-05-17 | 北京 (入) Beijing (Entry) | Entry |
## Page 5 (Pages 26-27) - U.S. F1 Visa #1 & Stamps
### U.S. Visa (First F1)
| Field | Value |
|---|---|
| **Visa Type/Class** | R / F1 |
| **Issuing Post Name** | BEIJING |
| **Surname** | JIANG |
| **Given Name** | XUEWEI |
| **Passport Number** | G49056249 |
| **Entries** | M |
| **Annotation** | N0008342296 / BAYLOR UNIVERSITY |
| **Issue Date** | 29JUN2011 |
| **Sex** | F |
| **Birth Date** | 13MAR1993 |
| **Expiration Date** | 27JUN2012 |
| **Nationality** | CHIN |
| **Control Number** | 20111799790007 *(approx)* |
| **Foil Number** | E3824515 |
### MRZ
```
VNUSAJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<<<
G49056249CCHN9303139F1206278F1BEJOWQZD131386
```
### Entry/Exit Stamps on Page 26-27
| Stamp | Date | Location | Type |
|---|---|---|---|
| U.S. CUSTOMS AND BORDER PROTECTION - ADMITTED SFR | AUG 11 2011 | SFR | Class F1, Until: *(D/S implied)*, No. 26 |
| U.S. CBP ADMITTED NYC | 1 1 2015 | NYC | Class: *(stamp)*, No. 9645 |
| 中国边检 CHINA | 2012-05-23 | 向(入) | Entry, No. 0298 |
| 中国边检 CHINA | 2011-06-11 | 北京 (出) Beijing (Exit) | Exit, No. 0380 *(approx)* |
| 中国边检 CHINA | 2014-05-16 | 北京 (入) Beijing (Entry) | Entry, No. 0459 |
## Page 6 (Pages 28-29) - U.S. F1 Visa #2 & Stamps
### U.S. Visa (Second F1)
| Field | Value |
|---|---|
| **Visa Type/Class** | R / F1 |
| **Issuing Post Name** | BEIJING |
| **Surname** | JIANG |
| **Given Name** | XUEWEI |
| **Passport Number** | G49056249 |
| **Entries** | M |
| **Annotation** | N0008342296 / BAYLOR UNIVERSITY |
| **Issue Date** | 27JUN2012 |
| **Sex** | F |
| **Birth Date** | 13MAR1993 |
| **Expiration Date** | 20JUN2013 |
| **Nationality** | CHIN |
| **Control Number** | 20121172537000l *(approx)* |
| **Foil Number** | F7633708 |
### MRZ
```
VNUSAJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<<<
G49056249CCHN9303139F1306204F1BEJJ164EP131384
```
### Entry/Exit Stamps on Pages 28-29
| Stamp | Date | Location | Type |
|---|---|---|---|
| 中国边检 CHINA | 2012-08-12 | 深圳湾 (出) Shenzhen Bay (Exit) | Exit, No. 0403 |
| 中国边检 CHINA | 2013-06-19 *(approx)* | 北京 (出) Beijing (Exit) | Exit, No. 0409 |
| U.S. HOMELAND SECURITY CBP - ADMITTED DAL | AUG 13 2012 | DAL | Class: *(stamp)*, No. 1983 |
| 中国边检 CHINA | 2016-07-21 | 北京 (入) Beijing (Entry) | Entry, No. 0918 |
## Page 7 (Pages 30-31) - Stamps
| Stamp | Date | Location | Type |
|---|---|---|---|
| 中国边检 (oval stamp) | 2017-12-08 | 北京 | *(entry/exit stamp)* |
| U.S. CUSTOMS AND BORDER PROTECTION - ADMITTED SND | JUN 19 2013 | SND | Class F1, Until D/S, No. 25 |
## Page 8 (Pages 38-39) - U.S. F1 Visa #3 & Stamps
### U.S. Visa (Third F1)
| Field | Value |
|---|---|
| **Visa Type/Class** | R / F1 |
| **Issuing Post Name** | GUANGZHOU |
| **Surname** | JIANG |
| **Given Name** | XUEWEI |
| **Passport Number** | G49056249 |
| **Entries** | M |
| **Annotation** | N0008342296 / BAYLOR UNIVERSITY |
| **Issue Date** | 03JUN2014 |
| **Sex** | F |
| **Birth Date** | 13MAR1993 |
| **Expiration Date** | 28MAY2015 |
| **Nationality** | CHIN |
| **Control Number** | 20141492020007 |
| **Foil Number** | J2193344 |
### MRZ
```
VNUSAJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<<<
G49056249CCHN9303139F1505281F1GUZ162GZ131389
```
### Entry/Exit Stamps on Pages 38-39
| Stamp | Date | Location | Type |
|---|---|---|---|
| U.S. CBP ADMITTED HOU | JUL 17 2014 | HOU | Class F-1, Until D/S, No. 53, E33 |
| 中国边检 CHINA | 2018-05-14 *(approx)* | 北京 (入) Beijing (Entry) | Entry, No. 1089 |
| 中国边检 CHINA | 2014-07-16 | 北京 (出) Beijing (Exit) | Exit, No. 0158 |
## Page 9 (Pages 40-41) - U.S. F1 Visa #4 & Stamps
### U.S. Visa (Fourth F1)
| Field | Value |
|---|---|
| **Visa Type/Class** | R / F1 |
| **Issuing Post Name** | BEIJING |
| **Surname** | JIANG |
| **Given Name** | XUEWEI |
| **Passport Number** | G49056249 |
| **Entries** | M |
| **Annotation** | N0008342296 / UNIVERSITY OF TEXAS AT AUSTIN |
| **Issue Date** | 27JUN2015 |
| **Sex** | F |
| **Birth Date** | 13MAR1993 |
| **Expiration Date** | 24JUN2020 |
| **Nationality** | CHIN |
| **Control Number** | 20151765120010 |
| **Foil Number** | J7942658 |
### MRZ
```
VNUSAJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<<<
G49056249CCHN9303139F2006246F1BEJ23GG431389
```
### Entry/Exit Stamps on Pages 40-41
| Stamp | Date | Location | Type |
|---|---|---|---|
| 中国边检 CHINA | 2015-08-10 | 北京 (出) Beijing (Exit) | Exit, No. 1079 |
| 中国边检 CHINA | 2016-08-10 | 北京 (出) Beijing (Exit) | Exit, No. 0863 |
| U.S. CBP ADMITTED LAX | AUG 10 2016 | LAX | Class F-1 *(or E-1)*, No. 27 |
| U.S. CBP ADMITTED LAX | JUN 04 2018 | LAX | Class: *(stamp)*, No. 27 |
| U.S. CBP ADMITTED SFR | JAN 09 2018 | SFR | Class: *(stamp)*, No. 28 |
| U.S. CBP ADMITTED *(location)* | AUG 1_ 2017 | *(unclear)* | Class: *(stamp)*, No. 4211 |
| 中国边检 CHINA | 2016-08-10 *(second stamp, possibly different date)* | 北京 | *(stamp)* |
## Page 10 (Page 48 + Back Cover) - Notes & Signature
Page 48: 签证 Visas -- blank.
### 注意事项 (Important Notes)
一、本护照为重要身份证件，持照人应妥为保存、使用，不得涂改、转让、故意损毁。任何组织或个人不得非法扣押。
二、本护照的签发、换发、补发和加注由公安部出入境管理机构或公安部委托的公安机关出入境管理机构，中国驻外使馆、领馆或外交部委托的其他驻外机构办理。
三、本护照遗失或被窃，在国内应立即向当地或户籍所在地的公安机关出入境管理机构报告；在国外应立即向当地或附近的中国驻外使馆、领馆或外交部委托的其他驻外机构报告。
四、短期出国的公民在国外发生护照遗失、被盗等情形，应向中国驻外使馆、领馆或外交部委托的其他驻外机构申请中华人民共和国旅行证。
### Bearer's Signature (持照人签名)
姜薛伟 *(handwritten signature)*

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---
type: dmv confirmation
category: REAL ID application
person: Xuewei Jiang
date: 2020-11-30
source: jiang_dmv_code.pdf
---
# DMV REAL ID Confirmation Code (ID.me)
**Page Title:** ID.me
**URL:** https://ca.real.id.me/en/submissions/33a4a2e2-8eb7-448f-940d-a53a44764f24/saved
**Date:** 11/30/2020
## Your Session Has Been Successfully Saved
An email with a link to resume your session has been sent to:
**xueweijiang0313@gmail.com**
**Ready to submit your documents to complete your REAL ID application?**
### Follow the link in the email
You'll be asked to sign in with your email and password with 2-factor authentication.
### Upload your documents for Pre-Screening
You'll need to submit images of originals or certified copies that prove your Identity, Social Security Number, and California Residency.
### Need to go to the DMV before you have finished uploading your documents?
Present the confirmation code below upon arrival at a DMV field office.
**This is your confirmation code:**
## 6055-F817
Show it to a DMV employee

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---
type: passport
category: identity document
person: Xuewei Jiang
date: 2021-07-13
source: jiang_passport_new.pdf
---
# Chinese Passport - Jiang Xuewei (New)
**Country:** People's Republic of China (中华人民共和国)
**Document:** Passport (护照)
## Passport Information
| Field | Value |
|---|---|
| **Type (类型)** | P |
| **Country Code (国家码)** | CHN |
| **Passport No. (护照号码)** | EJ4954380 |
| **Name (姓名)** | 姜薛伟 / JIANG, XUEWEI |
| **Sex (性别)** | 女 / F |
| **Nationality (国籍)** | 中国 / CHINESE |
| **Date of Birth (出生日期)** | 13 MAR 1993 |
| **Place of Birth (出生地点)** | 山东 / SHANDONG |
| **Date of Issue (签发日期)** | 13 7月/JUL 2021 |
| **Date of Expiry (有效期至)** | 12 7月/JUL 2031 |
| **Place of Issue (签发地点)** | 洛杉矶 / LOS ANGELES |
| **Authority (签发机关)** | 中国驻洛杉矶总领事馆 / CONSULATE GENERAL OF P.R.CHINA IN LOS ANGELES |
| **Bearer's Signature (持照人签名)** | 姜薛伟 |
## Machine Readable Zone (MRZ)
```
POCHNJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<<<
EJ49543806CHN9303139F3107128LNKKNBKGMOLAA942
```
## Header Page Text
中华人民共和国外交部请各国军政机关对持照人予以通行的便利和必要的协助。
*The Ministry of Foreign Affairs of the People's Republic of China requests all civil and military authorities of foreign countries to allow the bearer of this passport to pass freely and afford assistance in case of need.*
**Serial Number:** 188272287B
*Scanned with SwiftScan*

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---
type: lease agreement
category: residential lease
person: Yanxin Lu, Xuewei Jiang
date: 2020-11-17
source: lease.jpg
---
# Fixed Term Residential Lease Agreement
**Property Management:** The Adler Apartments
**Document Title:** FIXED TERM RESIDENTIAL LEASE AGREEMENT
This Fixed Term Residential Lease Agreement ("Lease") is entered into this **17th** day of **November, 2020**, by and between **ISSE RWS 11950 Idaho LLC** ("Landlord") dba, **The Adler Apartments** and **Yanxin Lu and Xuewei Jiang** (collectively, "Tenant(s)") to rent the premises located at **11950 Idaho Avenue #113, Los Angeles, CA, 90025**, including all appliances and furniture furnished therewith (collectively, the "Premises").
## 1. TERM
The term of this Lease is for a period of **1 year** commencing on **November 21, 2020** (the "Commencement Date") and thereafter expiring on **November 20, 2021** (the "Expiration Date"). Renewal of the Term shall be as described in Paragraph 40 herein.
## 2. RENT
Tenant(s) shall pay monthly "Base Rent" of **$3,280.00** plus a Code Enforcement surcharge of **$3.61** pursuant to the Los Angeles Housing Department Code Fee Addendum attached hereto for a total monthly payment of **$3,283.61** to The Adler Apartments on the 1st day of each month. (Should the rent term commence on a day other than the 1st, then Tenant(s) shall pay first month's Rent prior to move-in, and Tenant(s) shall pay a prorated amount of **$-649.47** for the second month's rent on the 1st day of second month). Rent payments shall be made by the following method(s): **Certified Funds or Checks and delivered to, The Adler Apartments 11960 Idaho Avenue, Los Angeles, CA, 90025, (310) 826-3100, Mon. - Sun. 9am-5pm.** All additional fees, charges and other sums Tenant(s) shall pay Landlord under this Lease are "Additional Rent" (Base Rent and Additional Rent are referred to as "Rent"). Additional rent includes, but is not limited to: pet rent, utility charges, returned check fees and late fees. Pursuant to Cal Civil Code 1479, Landlord may, without notice to Tenant(s), apply any payments that Landlord receives from Tenant(s) to any outstanding charges (whether Rent, late fees, damage or repair charges, returned check fees, utility charges, or other Additional Rent); if the payment Tenant(s) makes does not cover the total charges outstanding, then Tenant(s) will immediately pay the difference, plus any late fees.
*"AS REQUIRED BY LAW, YOU ARE HEREBY NOTIFIED THAT A NEGATIVE CREDIT REPORT REFLECTING ON YOUR CREDIT RECORD MAY BE SUBMITTED TO A CREDIT REPORTING AGENCY IF YOU FAIL TO FULFILL THE TERMS OF YOUR CREDIT OBLIGATIONS." California Civil Code 1785.26(c)(2).*
## 3. LATE CHARGE
Tenant(s) acknowledges that Landlord will incur certain administrative costs in connection with late rental payment, and that the amount of such administrative costs would be difficult or impracticable to ascertain. Tenant agrees that the following Late Charge is a reasonable estimate of the actual damages that Landlord would incur as a result of a late payment. If Tenant(s) fail to pay Tenant(s)'s entire outstanding rent balance in full by the close of business on the 3rd day of the month, Tenant(s) shall pay a Late Charge of 5% of the Rent as an Additional Rent. If Landlord elects to accept Rent after the Late Charge is incurred, payment in a form other than by personal check may be required. Notwithstanding the Late Charge provision, payment of Rent in full on the 1st day of each month is of the essence and failure to pay by the 1st shall subject Tenant(s) to immediate service of a three-day notice to pay or quit. In the event Tenant(s)'s check is dishonored by the bank, Tenant(s) shall pay a returned check charge of **$25.00** for the first returned check and **$35.00** for any subsequent returned check as additional Rent. A Late Charge will be imposed if the returned check causes the Rent to be late. Landlord may require future payments to be in a form other than a personal check in the event of a returned check.
## 4. SECURITY DEPOSIT
Tenant(s) shall deposit with Landlord a Security Deposit of **$1,000.00** as security for performance of the Lease (Total of all deposits not to exceed two (2) months' Rent for an unfurnished or three (3) months' Rent for a furnished unit). At no time shall any portion of this deposit be considered as an advance payment of rent (including last month's rent) nor shall Tenant have the right to use or receive any refund of the Security Deposit prior to the Premises being completely vacated by all Tenant(s). Notwithstanding the foregoing, Landlord shall have the right in its sole and absolute discretion to apply any portion of the security deposit at any time during the Term to any unpaid rent or any costs of repair or restoration due to Tenant's breach of this Lease. Within 10 days following written notice that Landlord has applied any portion of the Security Deposit, Tenant shall be obligated to restore the Security Deposit to its full original balances as required by this Lease. After the Premises are completely vacant, Landlord shall furnish Tenant(s) with an itemized written statement of the basis for, and the amount of, any security withheld and shall return any remaining portion of such security to Tenant(s) within twenty-one (21) days pursuant to California Civil Code §1950.5. The parties incorporate herein by reference the attached Security Deposit Refund and Move-Out Instructions Addendum as well as the Unit Inspection Report that the parties completed and executed prior to move-in documenting the condition of the Premises and inventory of furnishings. Tenant(s) will provide Landlord a written list of any items that Tenant(s) discovers are not in clean or operable condition within 3 days after Commencement Date. If the Premises are covered by the Los Angeles City Rent Stabilization Ordinance, Landlord shall annually credit Tenant(s) with interest on all security deposits held for at least one (1) year for Tenant(s).
## 5. UTILITIES
Tenant(s) shall pay for all utilities, services and charges applicable to the Premises. If utilities are separately metered, Tenant(s) shall place utilities in Tenant(s)' name as of the Commencement Date. If any utilities are not separately *(text cut off)*
---
**Page 1 of document**
**Tenant(s) Initials:** *(signed)*
**Date:** November 17, 2020
*Note: Only page 1 of the lease is visible in the source image. The document continues beyond what is shown.*

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---
type: insurance
category: renter's insurance
person: Yanxin Lu, Xuewei Jiang
date: 2020-11-21
source: renter_insurance.pdf
---
# Renter's Insurance - Evidence of Insurance (Assurant)
## Policy Information
| Field | Value |
|---|---|
| **Application Number** | REN0661408 |
| **Effective Dates** | 11/21/2020 to 11/21/2021 12:01 AM |
| **Yearly Premium** | $226.00 |
| **Service Phone** | 1-877-900-0344 |
## Agent & Company
| Agent Address | Company Address |
|---|---|
| GEICO Insurance Agency, Inc. | American Bankers Insurance Company of Florida |
| One Geico Blvd | 11222 Quail Roost Drive |
| Fredericksburg, VA 22412 | Miami, FL 33157-6596 |
## Insured & Risk Address
| Insured Name & Mailing Address | Risk Address |
|---|---|
| YANXIN LU | 11950 IDAHO AVE |
| XUEWEI JIANG | APT 113 |
| 11950 IDAHO AVE APT 113 | LOS ANGELES, CA 90025 |
| LOS ANGELES CA 90025 | |
## Section I Coverage Information
| Coverage | Amount ($) |
|---|---|
| CONTENTS | $10,000 |
| LOSS OF USE | $2,000 |
## Section I Deductible Information
| Deductible | Amount ($) |
|---|---|
| STANDARD DEDUCTIBLE | $500 |
## Section II Coverage Information
| Coverage | Amount ($) |
|---|---|
| PERSONAL LIABILITY | $100,000 |
| MEDICAL PAYMENTS TO OTHERS | $1,000 |
## Endorsements
- REPLACEMENT COST CONTENTS
- WATER SEWER BACKUP
**NOTE: ALL COVERAGES ARE SUBJECT TO THE TERMS AND CONDITIONS LISTED IN THE POLICY FORMS.**
Form: HISASEOI-1217 (Page 1)
---
## Payment Receipt (Page 2)
**Payment Receipt For Application # REN0661408**
| Field | Value |
|---|---|
| **Total Yearly Premium** | $226.00 |
| **Down Payment** | $226.00 |
| **Remaining Balance** | $0.00 |
| **Effective Dates** | 11/21/2020 12:01 AM to 11/21/2021 12:01 AM |
**For Service, Call 1-877-900-0344**
### Agent & Company (repeated)
| Agent Address | Company Address |
|---|---|
| GEICO Insurance Agency, Inc. | American Bankers Insurance Company of Florida |
| One Geico Blvd | 11222 Quail Roost Drive |
| Fredericksburg, VA 22412 | Miami, FL 33157-6596 |
### Insured & Risk Address (repeated)
| Insured Name & Mailing Address | Risk Address |
|---|---|
| YANXIN LU | 11950 IDAHO AVE |
| XUEWEI JIANG | APT 113 |
| 11950 IDAHO AVE APT 113 | LOS ANGELES CA 90025 |
| LOS ANGELES CA 90025 | |
### Additional Interest
| Additional Interest Name & Mailing Address |
|---|
| The Adler Apartments |
| 11950 IDAHO AVE |
| LOS ANGELES CA 90025 |
Form: HISASPR-1217 (Page 2)

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---
type: social security card
category: identity document
person: Xuewei Jiang
date: 2011-12-14
source: xuewei_ssn_front.jpeg
---
# Social Security Card - Xuewei Jiang (Front)
**Issuing Agency:** United States of America Social Security Administration
## Card Details
| Field | Value |
|---|---|
| **Restriction** | VALID FOR WORK ONLY WITH DHS AUTHORIZATION |
| **Social Security Number** | 092-99-3215 |
| **Name** | XUEWEI JIANG |
| **Signature** | Xuewei Jiang *(handwritten)* |
| **Date** | 12/14/2011 |
*"THIS NUMBER HAS BEEN ESTABLISHED FOR"*
*Card border text (repeating): SOCIAL SECURITY ADMINISTRATION UNITED STATES OF AMERICA*

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---
type: dmv confirmation
category: driver's license application
person: Yanxin Lu
date: 2021-07-28
source: lu_ca_dl_renew_2021.pdf
---
# DMV Drivers License Application - Confirmation
**Page Title:** DMV Drivers license application
**URL:** https://www.edl.dmv.ca.gov/apply/id-and-license/appointment-preparation
**Date:** 7/28/2021
## Status
We've received your information.
**You now need to go to the DMV!**
**This is your confirmation code:**
## 56B7-55B7
Show it to a DMV employee.
**Bring your required documents.**
For details about what you need to do to complete your application, visit the DMV website.
**Make an appointment to save time.**
---
Copyright 2018 State of California

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---
type: immigration document
category: I-94 admission record
person: Yanxin Lu
date: 2021-07-28
source: lu_i94.pdf
---
# I-94 Admission Record - Yanxin Lu
**Page Title:** I94 - Official Website
**URL:** https://i94.cbp.dhs.gov/I94/#/recent-results
**Date Retrieved:** 7/28/2021
**Agency:** U.S. Customs and Border Protection - Securing America's Borders
## Most Recent I-94
| Field | Value |
|---|---|
| **Admission (I-94) Record Number** | 289922390A2 |
| **Most Recent Date of Entry** | 2019 October 17 |
| **Class of Admission** | H1B |
| **Admit Until Date** | 08/04/2021 |
## I-94 Information Form Details
| Field | Value |
|---|---|
| **Last/Surname** | LU |
| **First (Given) Name** | YANXIN |
| **Birth Date** | 1989 October 17 |
| **Passport Number** | E93603635 |
| **Country of Issuance** | China |
## Notes
- Effective April 26, 2013, DHS began automating the admission process. An alien lawfully admitted or paroled into the U.S. is no longer required to be in possession of a preprinted Form I-94. A record of admission printed from the CBP website constitutes a lawful record of admission. See 8 CFR 1.4(d).
- If an employer, local, state or federal agency requests admission information, present your admission (I-94) number along with any additional required documents requested by that employer or agency.
- Note: For security reasons, we recommend that you close your browser after you have finished retrieving your I-94 number.
**OMB No.** 1651-0111
**Expiration Date:** 07/31/2021

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---
type: identity-document
category: drivers-license
person: Jiang Xuewei
date: 2015-12-17
source: Erica-dl-tx.pdf
---
# Texas Limited Term Driver License — Jiang Xuewei
## Front
| Field | Value |
|-------|-------|
| State | Texas, USA TX |
| Type | Limited Term Driver License |
| DL Number | 39313094 |
| Last Name (1) | JIANG |
| First Name (2) | XUEWEI |
| DOB (3) | 03/13/1993 |
| ISS (4a) | 12/17/2015 |
| EXP (4b) | 07/30/2020 |
| Class (9) | C |
| Address (8) | 2686 MURWORTH DRIVE APT 713, HOUSTON TX 77054 |
| Restrictions (12) | A |
| Sex (15) | F |
| Hgt (16) | 5-06 |
| Eyes (18) | BRO |
| End (9a) | NONE |
| DD (5) | 27616501124157967922 |
| Donor | Yes (DONOR heart symbol) |
Signature: Xuewei Jiang (handwritten)
## Back
| Field | Value |
|-------|-------|
| RESTRICTIONS | A - With corrective lenses |
| ENDORSEMENTS | NONE |
| Directive to physician has been filed at tell # | ☐ (unchecked) |
| Emergency contact number | ☐ (unchecked) |
| Allergic reaction to drugs | ☐ (unchecked) |
| Texas Roadside Assistance | 1-800-525-5555 |
| REV. | 06/01/2007 |
2D barcode and 1D barcode on the back.

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---
type: identity-document
category: china-id
person: Jiang
date: 2009-05-11
source: china_id_back_jiang.jpg
---
# China Resident Identity Card (Back) — Jiang
**Document Title:** 中华人民共和国 居民身份证
| Field | Value |
|-------|-------|
| 签发机关 (Issuing Authority) | 济南市公安局天桥分局 |
| 有效期限 (Validity Period) | 2009.05.11–2019.05.11 |
National emblem of China and Great Wall watermark visible on card.
Scanned by TapScanner.

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---
type: identity-document
category: china-id
person: Jiang Xuewei
date: 1993-03-13
source: china_id_jiang.jpg
---
# China Resident Identity Card (Front) — Jiang Xuewei
| Field | Value |
|-------|-------|
| 姓名 (Name) | 姜薛伟 |
| 性别 (Sex) | 女 (Female) |
| 民族 (Ethnicity) | 汉 (Han) |
| 出生 (Date of Birth) | 1993年3月13日 |
| 住址 (Address) | 济南市天桥区黄台南路79号1号楼1单元401号 |
| 公民身份号码 (Citizen ID Number) | 370105199303130825 |
Photo: Female, black hair, on the right side of the card.

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---
type: identity-document
category: china-id
person: Jiang Xuewei
date: 2022-01-17
source: jiang-china-id-2022.pdf
---
# China Resident Identity Card (2022) — Jiang Xuewei
## Front
| Field | Value |
|-------|-------|
| 姓名 (Name) | 姜薛伟 |
| 性别 (Sex) | 女 (Female) |
| 民族 (Ethnicity) | 汉 (Han) |
| 出生 (Date of Birth) | 1993年3月13日 |
| 住址 (Address) | 济南市天桥区黄台南路79号1号楼1单元401号 |
| 公民身份号码 (Citizen ID Number) | 370105199303130825 |
Photo: Female, black hair, right side of card.
## Back
| Field | Value |
|-------|-------|
| Document Title | 中华人民共和国 居民身份证 |
| 签发机关 (Issuing Authority) | 济南市公安局天桥分局 |
| 有效期限 (Validity Period) | 2022.01.17–2042.01.17 |
National emblem of China and Great Wall watermark visible.

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---
type: identity-document
category: drivers-license
person: Jiang Xuewei
date: 2021-07-29
source: jiang_dl_ca.jpg
---
# California Driver License — Jiang Xuewei
| Field | Value |
|-------|-------|
| State | California, USA |
| Type | DRIVER LICENSE |
| DL Number | Y1661483 |
| Class | C |
| Term | LIMITED-TERM |
| END | NONE |
| EXP | 03/13/2026 |
| LN (Last Name) | JIANG |
| FN (First Name) | XUEWEI |
| Address | 11950 IDAHO AVE APT 113, LOS ANGELES, CA 90025 |
| DOB | 03/13/1993 |
| RSTR (Restrictions) | CORR LENS |
| SEX | F |
| HGT | 5'-06" |
| HAIR | BLK |
| WGT | 145 lb |
| EYES | BRN |
| ISS | 03131993 |
| DD | 07/29/2021616E8/ |
Signature: Xuewei Jiang (handwritten)
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---
type: medical-record
category: vaccination
person: Jiang Xuewei (Erica)
date: 2021-11-24
source: jiang_vaccine_3rd_shot.jpg
---
# COVID-19 Vaccination Record Card — Jiang Erica (Xuewei)
| Field | Value |
|-------|-------|
| Last Name | Jiang |
| First Name | Erica (Xuewei) |
| MI | — |
| Date of Birth | 03/13/1993 |
| Patient Number | — |
## Vaccination Records
| Dose | Vaccine | Product Name/Manufacturer | Lot Number | Date | Healthcare Professional or Clinic Site |
|------|---------|--------------------------|------------|------|---------------------------------------|
| 1st Dose COVID-19 | Pfizer | Pfizer | ER8729 | 4/6/21 | LAFD USC |
| 2nd Dose COVID-19 | Pfizer | Pfizer | EW 0171 | 4/27/21 | LAFD - USC |
| Other | Pfizer | Pfizer | FJ1620 | 11/24/21 | USC Pharmacy |
| Other | — | — | — | — | — |
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---
type: identity-document
category: china-id
person: Lu Yanxin
date: 2017-12-21
source: lu-china-id.pdf
---
# China Resident Identity Card — Lu Yanxin (陆彦忻)
## Front
| Field | Value |
|-------|-------|
| 姓名 (Name) | 陆彦忻 |
| 性别 (Sex) | 男 (Male) |
| 民族 (Ethnicity) | 汉 (Han) |
| 出生 (Date of Birth) | 1989年10月17日 |
| 住址 (Address) | 广州市番禺区市良路9号美园东一街二座一梯102房 |
| 公民身份号码 (Citizen ID Number) | 440181119891017001X |
Photo: Male, black hair, right side of card.
## Back
| Field | Value |
|-------|-------|
| Document Title | 中华人民共和国 居民身份证 |
| 签发机关 (Issuing Authority) | 广州市公安局番禺分局 |
| 有效期限 (Validity Period) | 2017.12.21–2037.12.21 |
National emblem of China and Great Wall watermark visible.

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---
type: identity-document
category: drivers-license
person: Lu Yanxin
date: 2021-07-29
source: lu-dl-ca-2021.jpeg
---
# California Driver License (2021) — Lu Yanxin
| Field | Value |
|-------|-------|
| State | California, USA |
| Type | DRIVER LICENSE |
| DL Number | Y5869348 |
| Class | C |
| Term | LIMITED-TERM |
| END | NONE |
| EXP | 10/17/2023 |
| LN (Last Name) | LU |
| FN (First Name) | YANXIN |
| Address | 11950 IDAHO AVE APT 113, LOS ANGELES, CA 90025 |
| DOB | 10/17/1989 |
| RSTR (Restrictions) | CORR LENS |
| SEX | M |
| HGT | 5'-09" |
| HAIR | BRN |
| WGT | 125 lb |
| EYES | BLK |
| ISS | 07/29/2021 |
| ID Number (small print) | 10171989 |
| DD | 07/29/2021616O5/... (partially obscured) |
Signature: handwritten signature present.
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---
type: identity-document
category: drivers-license
person: Lu Yanxin
date: 2017-08-28
source: lu_ca_dl_2026_back.jpg
---
# California Driver License (Back) — Lu
| Field | Value |
|-------|-------|
| CLASS | C - Veh w/GVWR ≤26000, No M/C |
| ENDORSEMENTS | None |
| RESTRICTIONS | 01-Must wear corrective lenses when driving |
| Disclaimer | This license is issued as a license to drive a motor vehicle, it does not establish eligibility for employment, voter registration, or public benefits. |
| Number (bottom left) | 101789 |
| DD (bottom) | 23220Y58693404O1 |
| Rev | 08/28/2017 |
Signature: handwritten signature present.
2D barcode and 1D barcode on the back.

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---
type: identity-document
category: drivers-license
person: Lu Yanxin
date: 2023-08-08
source: lu_ca_dl_2026_front.jpg
---
# California Driver License (Front) — Lu Yanxin
| Field | Value |
|-------|-------|
| State | California, USA |
| Type | DRIVER LICENSE |
| DL Number | Y5869348 |
| Class | C |
| Term | LIMITED-TERM |
| END | NONE |
| EXP | 10/17/2028 |
| LN (Last Name) | LU |
| FN (First Name) | YANXIN |
| Address | 12421 SANFORD ST, LOS ANGELES, CA 90066 |
| DOB | 10/17/1989 |
| RSTR (Restrictions) | CORR LENS |
| SEX | M |
| HGT | 5'-09" |
| HAIR | BRN |
| WGT | 125 lb |
| EYES | BLK |
| ISS | 08/08/2023 |
| ID Number (small print) | 10171989 |
| Number (bottom left) | 101789 |
| DD | 07/29/2021616RB/DDFD/28 |
Signature: handwritten signature present.

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---
type: medical-record
category: vaccination
person: Lu Yanxin
date: 2021-05-06
source: lu_vaccine_2nd_shot.jpg
---
# COVID-19 Vaccination Record Card — Lu Yanxin
Two cards are shown in this image (original and replacement/updated).
## Card 1 (Top)
| Field | Value |
|-------|-------|
| Last Name | Lu |
| First Name | Yanxin |
| MI | — |
| Date of Birth | 10/17/1989 |
| Patient Number | — |
| Dose | Vaccine | Lot # | EXP | Date | Healthcare Professional or Clinic Site |
|------|---------|-------|-----|------|---------------------------------------|
| 1st Dose COVID-19 | PFIZER COVID-19 VACCINE | EW0161 | 07/31/2021 | 4/15/2021 | FORUM |
| 2nd Dose COVID-19 | — | — | — | — | — |
| Other | — | — | — | — | — |
| Other | — | — | — | — | — |
## Card 2 (Bottom)
| Field | Value |
|-------|-------|
| Last Name | Lu |
| First Name | Yanxin |
| MI | — |
| Date of Birth | 10-17-1989 |
| Patient Number | — |
| Dose | Vaccine | Product Name/Manufacturer | Lot Number | Date | Healthcare Professional or Clinic Site |
|------|---------|--------------------------|------------|------|---------------------------------------|
| 1st Dose COVID-19 | Pfizer | Pfizer | EW0161 | 4/15/21 | Forum |
| 2nd Dose COVID-19 | PFIZER COVID-19 VACCINE | — | EW0173 | 5/6/2021 (EXP: 08/31/2021) | FORUM |
| Other | — | — | — | — | — |
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---
type: identity-document
category: birth-certificate
person: Nichol Li
date: 2023-11-22
source: nichol-birth-cert-la.pdf
---
# Certificate of Live Birth — Nichol Li
**State of California, County of Los Angeles, Department of Public Health**
**State File Number:** 1202319076052
## Child Information
| Field | Value |
|-------|-------|
| 1A. Name of Child - First | NICHOL |
| 1B. Middle | — |
| 1C. Last | LI |
| 2. Sex | MALE |
| 3A. This Birth: Single, Twin, etc. | SINGLE |
| 3B. If Multiple, This Child 1st, 2nd, etc. | — |
| 4A. Date of Birth - MM/DD/CCY | 11/22/2023 |
| 4B. Hour - 24 Hour Clock Time | 2345 |
## Place of Birth
| Field | Value |
|-------|-------|
| 5A. Place of Birth - Name of Hospital or Facility | USC ARCADIA HOSPITAL |
| 5B. Street Address - Street and Number, or Location | 300 W. HUNTINGTON DR |
| 5C. City | ARCADIA |
| 5D. County | LOS ANGELES |
## Parent 1 (Father)
| Field | Value |
|-------|-------|
| 6A. Name of Parent - First | CHENG |
| 6B. Middle | — |
| 6C. Last - Birth Name | LI |
| 7. Birthplace - State/Country | CHINA |
| 8. Date of Birth | 06/16/1987 |
| Relationship to Child | FATHER |
## Parent 2 (Mother)
| Field | Value |
|-------|-------|
| 9A. Name of Parent - First | XIANG |
| 9B. Middle | — |
| 9C. Last - Birth Name | ZHANG |
| 10. Birthplace - State/Country | CHINA |
| 11. Date of Birth | 03/16/1990 |
| Relationship to Child | MOTHER |
## Informant and Birth Certification
| Field | Value |
|-------|-------|
| 12A. Parent or Other Informant - Signature | CHENG LI |
| 12B. Relationship to Child | FATHER |
| 12C. Date Signed | 11/23/2023 |
| — | XIANG ZHANG |
| Relationship | MOTHER |
| Date Signed | 11/23/2023 |
| 13A. Attendant/Certifier - Signature and Degree or Title | BESSIE NHAN, BIRTH. REG. |
| 13B. Number | A64425 |
| 13C. Date Signed | 11/24/2023 |
| 13D. Typed Name, Title and Mailing Address of Attendant | CINDY HUANG CHOU, MD, 207 S SANTA ANITA ST STE 335, SAN GABRIEL, CA 91776 |
| 14. Typed Name and Title of Certifier if Other Than Attendant | BESSIE NHAN, BIRTH. REG. |
| 16. Local Registrar - Signature | MUNTU DAVIS MD |
| 17. Date Accepted for Registration | 11/27/2023 |
## Certification
**CERTIFIED COPY OF VITAL RECORD** — State of California, County of Los Angeles
This is a true certified copy of the record filed in the County of Los Angeles Department of Public Health if it bears the Registrar's signature in purple ink.
- Health Officer and Registrar: VG, MD
- Date Issued: NOV 27, 2023
- Barcode: *004097660*
Seal of the County of Los Angeles and State of California present.
"This copy not valid unless prepared on engraved border displaying seal and signature of Registrar."
"ANY ALTERATION OR ERASURE VOIDS THIS CERTIFICATE"

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---
type: identity-document
category: passport
person: Nichol Li
date: 2023-12-06
source: nichol-passport.pdf
---
# United States Passport — Nichol Li
## Passport Data Page
| Field | Value |
|-------|-------|
| Type/Type/Tipo | P |
| Code/Code/Codigo | USA |
| Passport No./No. du Passeport/No. de Pasaporte | A30777626 |
| Surname/Nom/Apellidos | LI |
| Given Names/Prenoms/Nombres | NICHOL |
| Nationality/Nationalite/Nacionalidad | UNITED STATES OF AMERICA |
| Date of Birth/Date de naissance/Fecha de nacimiento | 22 NOV 2023 |
| Sex/Sexe/Sexo | M |
| Place of Birth/Lieu de naissance/Lugar de nacimiento | CALIFORNIA, U.S.A. |
| Date of Issue/Date de delivrance/Fecha de expedicion | 06 DEC 2023 |
| Date of Expiration/Date d'expiration/Fecha de caducidad | 05 DEC 2028 |
| Authority/Autorite/Autoridad | UNITED STATES DEPARTMENT OF STATE |
## Machine Readable Zone (MRZ)
```
P<USALI<<NICHOL<<<<<<<<<<<<<<<<<<<<<<<<<<<
A307776260USA2311229M2812058621256087<883372
```
## Endorsements Page
"If your passport expires within six months of your date of departure, you may be denied entry into some countries."
Signature of Bearer: (none — infant)
Photo: Infant, on the left side of the data page. Small ghost photo on bottom right.

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---
type: identity-document
category: social-security-card
person: Nichol Li
date: 2023-11-29
source: nichol-ssn.pdf
---
# Social Security Card — Nichol Li
## Card
| Field | Value |
|-------|-------|
| Social Security Number | 390-97-7047 |
| Name | NICHOL LI |
| Statement | THIS NUMBER HAS BEEN ESTABLISHED FOR |
| Signature | (unsigned — child) |
| Date Issued | 11/29/2023 |
## Mailing Stub
| Field | Value |
|-------|-------|
| Name | NICHOL LI |
| Address | 12421 SANFORD ST, LOS ANGELES CA 90066-6954 |
Instructions on stub: "Keep this stub with your personal records. The other side contains important information. Please note: The date we issued this card is shown below the signature line."
Instructions on card: "ADULTS: Sign this card in ink immediately. CHILDREN: Do not sign until age 18 or your first job, whichever is earlier. Keep your card in a safe place to prevent loss or theft. DO NOT CARRY THIS CARD WITH YOU. Do not laminate."

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---
type: identity-document
category: passport
person: Jiang Xuewei
date: 2021-07-13
source: passport_jiang_2021.jpg
---
# People's Republic of China Passport — Jiang Xuewei (姜薛伟)
**中华人民共和国 护照 / PEOPLE'S REPUBLIC OF CHINA PASSPORT**
| Field | Value |
|-------|-------|
| 类型/Type | P |
| 国家码/Country Code | CHN |
| 护照号码/Passport No. | EJ4954380 |
| 姓名/Name | 姜薛伟 / JIANG, XUEWEI |
| 性别/Sex | 女/F |
| 国籍/Nationality | 中国/CHINESE |
| 出生日期/Date of Birth | 13 MAR 1993 |
| 出生地点/Place of Birth | 山东/SHANDONG |
| 签发日期/Date of Issue | 13 7月/JUL 2021 |
| 签发地点/Place of Issue | 洛杉矶/LOS ANGELES |
| 有效期至/Date of Expiry | 12 7月/JUL 2031 |
| 签发机关/Authority | 中国驻洛杉矶总领事馆 / CONSULATE GENERAL OF P.R.CHINA IN LOS ANGELES |
| 持照人签名/Bearer's Signature | 姜薛伟 |
## Machine Readable Zone (MRZ)
```
POCHNJIANG<<XUEWEI<<<<<<<<<<<<<<<<<<<<<<<<
EJ49543806CHN9303139F3107128LNKKNBKGMOLAA942
```
Number on right side: 18B2722878
Photo: Female, black hair, left side. Ghost photo on right side.
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---
type: identity-document
category: passport
person: Lu Yanxin
date: 2017-03-28
source: passport_lu_2017.pdf
---
# People's Republic of China Passport — Lu Yanxin (陆彦忻)
**中华人民共和国 护照 / PEOPLE'S REPUBLIC OF CHINA PASSPORT**
## Request Page
中华人民共和国外交部请各国军政机关对持照人予以通行的便利和必要的协助。
The Ministry of Foreign Affairs of the People's Republic of China requests all civil and military authorities of foreign countries to allow the bearer of this passport to pass freely and afford assistance in case of need.
## Data Page
| Field | Value |
|-------|-------|
| 类型/Type | P |
| 国家码/Country Code | CHN |
| 护照号码/Passport No. | E93603635 |
| 姓名/Name | 陆彦忻 / LU, YANXIN |
| 性别/Sex | 男/M |
| 国籍/Nationality | 中国/CHINESE |
| 出生日期/Date of Birth | 17 OCT 1989 |
| 出生地点/Place of Birth | 贵州/GUIZHOU |
| 签发日期/Date of Issue | 28 3月/MAR 2017 |
| 签发地点/Place of Issue | 休斯敦/HOUSTON |
| 有效期至/Date of Expiry | 27 3月/MAR 2027 |
| 签发机关/Authority | 中国驻休斯敦总领事馆 / CONSULATE GENERAL OF P.R.CHINA IN HOUSTON |
| 持照人签名/Bearer's Signature | (handwritten signature) |
Number on right side: 096583182I
## Machine Readable Zone (MRZ)
```
POCHNLU<<YANXIN<<<<<<<<<<<<<<<<<<<<<<<<<<<
E936036359CHN8910174M2703279MCLNNBOFNAMDA940
```
Photo: Male, on the left side of the data page. Ghost photo on the right side.

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---
type: driver-license
category: id
person: Yanxin Lu
date: 2019-02-14
source: yanxin-dl-tx.pdf
---
# Yanxin Lu — California Driver License (Limited-Term)
## Front
| Field | Value |
|-------|-------|
| State | California |
| Document Type | Driver License |
| DL # | Y5869348 |
| Class | C |
| LN | LU |
| FN | YANXIN |
| Address | 1000 ESCALON AVE APT K2087, SUNNYVALE, CA 94085 |
| DOB | 10/17/1989 |
| EXP | 08/05/2021 |
| ISS | 02/14/2019 |
| RSTR | CORR LENS |
| SEX | M |
| HGT | 5'-09" |
| WGT | 125 lb |
| HAIR | BLK |
| EYES | BRN |
| DD | 02/14/20191605/BBFD/23 |
| Term | LIMITED-TERM, END NONE |
## Back
| Field | Value |
|-------|-------|
| CLASS | C - Veh w/GVWR ≤26000, No M/C |
| ENDORSEMENTS | None |
| RESTRICTIONS | 01 - Must wear corrective lenses when driving |
| Rev | 08/29/2017 |
| Number | 101789 |
| Barcode ID | 19045Y586934804O2 |
> This license is issued as a license to drive a motor vehicle; it does not establish eligibility for employment, voter registration, or public benefits.
## Notes
- Despite the filename containing "tx" (Texas), this is a **California** driver license issued in Sunnyvale, CA.
- Limited-term license with no specified end date.

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---
type: translation
category: marriage
person:
- Lu Yanxin
- Jiang Xuewei
date: 2016-08-08
source: marriage.docx
---
# Marriage Certificate Translation (Word Document)
This document contains bilingual (Chinese/English) translations of both Yanxin Lu's and Xuewei Jiang's copies of the marriage certificate, plus a translator certification page.
> Note: The content is the same translation text found in `marriage_cert.pdf` (pages 4-6 and 10-12), presented here as an editable Word document.
---
## Yanxin Lu's Copy
### 结婚证第一页 / Page 1
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang
### 结婚证第二页 / Page 2
| Chinese | English |
|---|---|
| 持证人: 陆彦忻 | Certificate Holder: Yanxin Lu |
| 登记日期: 2016年08月08日 | Registration Date: August. 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1:**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |
**Person 2:**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
### 结婚证第三页 / Page 3
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
---
## Xuewei Jiang's Copy
### 结婚证第一页 / Page 1
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang
### 结婚证第二页 / Page 2
| Chinese | English |
|---|---|
| 持证人: 姜薛伟 | Certificate Holder: Xuewei Jiang |
| 登记日期: 2016年08月08日 | Registration Date: August. 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1:**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
**Person 2:**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |
### 结婚证第三页 / Page 3
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
---
## Certification by Translator
I, Xue Li, certify that I am fluent in the English and Chinese languages, and that the above/attached document is an accurate translation of the document attached entitled Marriage Certificate.
| Field | Value |
|---|---|
| Signature | (signed) |
| Date | 08/13/2016 |
| Printed Name | Xue Li |
| Address | (listed in document) |

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---
type: certificate
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-08
source: marriage_cert.pdf
---
# Marriage Certificate (Combined PDF - Xuewei & Yanxin Copies with Translations)
This 13-page PDF contains scanned images of both Xuewei Jiang's and Yanxin Lu's copies of their Chinese marriage certificate, along with certified English translations and a translator certification page.
---
## Part 1: Xuewei Jiang's Marriage Certificate (Chinese Original Scans)
### Page 1 (Certificate Inner Cover - Left & Right Spread)
**Left Page:**
- Seal: 中华人民共和国民政部 (Ministry of Civil Affairs of the People's Republic of China) — national emblem seal in red
- Footer: 中华人民共和国民政部监制 (Supervised by the Ministry of Civil Affairs of the People's Republic of China)
**Right Page:**
- Text: 结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。
- 登记机关 (Registration Office): Seal of 济南市天桥区区民政局婚姻登记专用章 (Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau)
- 婚姻登记员 (Marriage Registrar): 王燕 (Wang Yan) — handwritten signature
### Page 2 (Certificate Details Page)
**Upper Section:**
- 持证人 (Certificate Holder): **姜薛伟**
- 登记日期 (Registration Date): **2016年08月08日**
- 结婚证字号 (Marriage Certificate No.): **J370105-2016-002657**
- 备注 (Annotation): (blank)
- Photo: Couple photo (woman on left, man on right) with official stamp overlay
**Lower Section:**
| Field (Chinese) | Value | Field (Chinese) | Value |
|---|---|---|---|
| 姓名 | 姜薛伟 | 性别 | 女 |
| 国籍 | 中国 | 出生日期 | 1993年03月13日 |
| 身份证件号 | 370105199303130825 | | |
| Field (Chinese) | Value | Field (Chinese) | Value |
|---|---|---|---|
| 姓名 | 陆彦忻 | 性别 | 男 |
| 国籍 | 中国 | 出生日期 | 1989年10月17日 |
| 身份证件号 | 44018119891017001X | | |
- Footer: **M Z H B J Z H**
### Page 3 (Back Cover - Left & Right Spread)
**Left Page:**
- Text: 婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。
**Right Page:**
- Serial Number: **No 0341002847**
- Decorative floral medallion
---
## Part 2: Xuewei Jiang's Certified English Translation
### Page 4 (结婚证第一页 / Page 1)
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang
### Page 5 (结婚证第二页 / Page 2)
| Chinese | English |
|---|---|
| 持证人: 姜薛伟 | Certificate Holder: Xuewei Jiang |
| 登记日期: 2016年08月08日 | Registration Date: August 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1:**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
**Person 2:**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |
### Page 6 (结婚证第三页 / Page 3)
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
**Signed by:** Xuewei Jiang (signature: X [cursive])
**Notarization:**
- State of Texas, County of Travis
- This instrument was acknowledged before me on the 13th day of August, 2016
- by Xuewei Jiang
- Notary Public (signed)
- Notary Stamp: LUIS BARRERA, Notary Public, State of Texas, My Commission Expires August 19, 2019
---
## Part 3: Yanxin Lu's Marriage Certificate (Chinese Original Scans)
### Page 7 (Certificate Inner Cover - Left & Right Spread)
**Left Page:**
- Seal: 中华人民共和国民政部 (Ministry of Civil Affairs of the People's Republic of China) — national emblem seal in red
- Footer: 中华人民共和国民政部监制
**Right Page:**
- Text: 结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。
- 登记机关: Seal of 济南市天桥区区民政局婚姻登记专用章
- 婚姻登记员: 王燕 (Wang Yan) — handwritten signature
### Page 8 (Back Cover - Left & Right Spread)
**Left Page:**
- Text: 婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。
**Right Page:**
- Serial Number: **No 0341002846**
- Decorative floral medallion
### Page 9 (Certificate Details Page)
**Upper Section:**
- 持证人 (Certificate Holder): **陆彦忻**
- 登记日期 (Registration Date): **2016年08月08日**
- 结婚证字号 (Marriage Certificate No.): **J370105-2016-002657**
- 备注 (Annotation): (blank)
- Photo: Couple photo (woman on left, man on right) with official stamp overlay
**Lower Section:**
| Field (Chinese) | Value | Field (Chinese) | Value |
|---|---|---|---|
| 姓名 | 陆彦忻 | 性别 | 男 |
| 国籍 | 中国 | 出生日期 | 1989年10月17日 |
| 身份证件号 | 44018119891017001X | | |
| Field (Chinese) | Value | Field (Chinese) | Value |
|---|---|---|---|
| 姓名 | 姜薛伟 | 性别 | 女 |
| 国籍 | 中国 | 出生日期 | 1993年03月13日 |
| 身份证件号 | 370105199303130825 | | |
- Footer: **M Z H B J Z H**
---
## Part 4: Yanxin Lu's Certified English Translation
### Page 10 (结婚证第一页 / Page 1)
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang
### Page 11 (结婚证第二页 / Page 2)
| Chinese | English |
|---|---|
| 持证人: 陆彦忻 | Certificate Holder: Yanxin Lu |
| 登记日期: 2016年08月08日 | Registration Date: August 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1:**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |
**Person 2:**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
### Page 12 (结婚证第三页 / Page 3)
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
**Signed by:** Yanxin Lu (signature: X [cursive])
**Notarization:**
- State of Texas, County of Travis
- This instrument was acknowledged before me on the 13th day of August, 2016
- by Yanxin Lu
- Notary Public (signed)
- Notary Stamp: LUIS BARRERA, Notary Public, State of Texas, My Commission Expires August 19, 2019
---
## Page 13: Certification by Translator
**Certification by Translator**
I, Xue Li, certify that I am fluent in the English and Chinese languages, and that the above/attached document is an accurate translation of the document attached entitled Marriage Certificate.
| Field | Value |
|---|---|
| Signature | (signed) |
| Date | 08/13/2016 |
| Printed Name | Xue Li |
| Address | 3500 Greystone Drive, Apt. 270, Austin, TX 78731 |
**Notarization:**
- State of Texas, County of Travis
- This instrument was acknowledged before me on the 13th day of August, 2016
- by Xue Li
- Notary Public (signed)
- Notary Stamp: LUIS BARRERA, Notary Public, State of Texas, My Commission Expires August 19, 2019

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---
type: translation
category: marriage
person:
- Lu Yanxin
- Jiang Xuewei
date: 2016-08-08
source: marriage.pdf
---
# Marriage Certificate Translation (PDF - 7 Pages)
This 7-page PDF contains the bilingual (Chinese/English) translation of both copies of the marriage certificate (Yanxin Lu's copy first, then Xuewei Jiang's copy), plus a translator certification page. The Printed Name and Address fields on the certification page are blank in this version (unlike the signed JPEG version).
> Note: The translation text content is identical to that in `marriage.docx` and overlaps with pages 4-6 and 10-12 of `marriage_cert.pdf`.
---
## Yanxin Lu's Copy
### 结婚证第一页 / Page 1
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang
### 结婚证第二页 / Page 2
| Chinese | English |
|---|---|
| 持证人: 陆彦忻 | Certificate Holder: Yanxin Lu |
| 登记日期: 2016年08月08日 | Registration Date: August. 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1:**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |
**Person 2:**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
### 结婚证第三页 / Page 3
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
---
## Xuewei Jiang's Copy
### 结婚证第一页 / Page 1
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang
### 结婚证第二页 / Page 2
| Chinese | English |
|---|---|
| 持证人: 姜薛伟 | Certificate Holder: Xuewei Jiang |
| 登记日期: 2016年08月08日 | Registration Date: August. 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1:**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
**Person 2:**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |
### 结婚证第三页 / Page 3
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
---
## Page 7: Certification by Translator
I, Xue Li, certify that I am fluent in the English and Chinese languages, and that the above/attached document is an accurate translation of the document attached entitled Marriage Certificate.
| Field | Value |
|---|---|
| Signature | (blank — unsigned version) |
| Date | 08/13/2016 |
| Printed Name | (blank) |
| Address | (blank) |
> Note: This is the unsigned template version of the translator certification. The signed version with filled-in name and address appears in `marriage_trans_cert.jpeg` and page 13 of `marriage_cert.pdf`.

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---
type: certificate
category: marriage-translation
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-13
source: marriage_trans_cert.jpeg
---
# Certification by Translator
> Note: This image is identical in content to page 13 of `marriage_cert.pdf`.
**Certification by Translator**
I, Xue Li, certify that I am fluent in the English and Chinese languages, and that the above/attached document is an accurate translation of the document attached entitled Marriage Certificate.
| Field | Value |
|---|---|
| Signature | (signed) |
| Date | 08/13/2016 |
| Printed Name | Xue Li |
| Address | 3500 Greystone Drive, Apt. 270, Austin, TX 78731 |
**Notarization:**
- State of Texas, County of Travis
- This instrument was acknowledged before me on the 13th day of August, 2016
- by Xue Li
- Notary Public (signed)
- Notary Stamp: LUIS BARRERA, Notary Public, State of Texas, My Commission Expires August 19, 2019

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---
type: certificate
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-08
source: xuewei_marriage_cert.pdf
---
# Xuewei Marriage Certificate (PDF - 3 Pages, Chinese Original Scans)
> Note: This 3-page PDF contains the same scanned images as `xuewei_marriage_cert_1.jpeg`, `xuewei_marriage_cert_2.jpeg`, and `xuewei_marriage_cert_3.jpeg`. It is also identical to pages 1-3 of `marriage_cert.pdf`.
## Page 1: Inner Cover Spread
**Left Page:**
- Seal: 中华人民共和国民政部 婚姻证 (Ministry of Civil Affairs of the People's Republic of China - Marriage Certificate) — national emblem seal in red
- Footer: 中华人民共和国民政部监制
**Right Page:**
- Text: 结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。
- 登记机关: Red seal — 济南市天桥区区民政局婚姻登记专用章
- 婚姻登记员: 王燕 (Wang Yan) — handwritten signature
- Gray embossed seal also visible
## Page 2: Certificate Details Page
**Upper Section:**
| Field (Chinese) | Value |
|---|---|
| 持证人 (Certificate Holder) | 姜薛伟 |
| 登记日期 (Registration Date) | 2016年08月08日 |
| 结婚证字号 (Marriage Certificate No.) | J370105-2016-002657 |
| 备注 (Annotation) | (blank) |
- Couple photo with official stamp overlay
**Lower Section - Wife:**
| Field | Value |
|---|---|
| 姓名 (Name) | 姜薛伟 |
| 性别 (Gender) | 女 (Female) |
| 国籍 (Nationality) | 中国 (China) |
| 出生日期 (Date of Birth) | 1993年03月13日 |
| 身份证件号 (ID Number) | 370105199303130825 |
**Lower Section - Husband:**
| Field | Value |
|---|---|
| 姓名 (Name) | 陆彦忻 |
| 性别 (Gender) | 男 (Male) |
| 国籍 (Nationality) | 中国 (China) |
| 出生日期 (Date of Birth) | 1989年10月17日 |
| 身份证件号 (ID Number) | 44018119891017001X |
- Footer: **M Z H B J Z H**
## Page 3: Back Cover Spread
**Left Page:**
- 婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。
**Right Page:**
- Decorative floral medallion
- Serial Number: **No 0341002847**

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---
type: certificate
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-08
source: xuewei_marriage_cert_1.jpeg
---
# Xuewei Marriage Certificate - Page 1 (Chinese Original)
> Note: This image is identical to page 1 of `marriage_cert.pdf` (Xuewei's copy). It shows the inner cover spread of the marriage certificate booklet.
## Left Page
- Seal: 中华人民共和国民政部 婚姻证 (Ministry of Civil Affairs of the People's Republic of China - Marriage Certificate) — national emblem seal in red
- Footer: 中华人民共和国民政部监制 (Supervised by the Ministry of Civil Affairs of the People's Republic of China)
## Right Page
- Text: 结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。
- (The marriage application conforms to the Marriage Law of the People's Republic of China; registration is hereby granted and this certificate is issued.)
- 登记机关 (Registration Office): Red seal — 济南市天桥区区民政局婚姻登记专用章 (Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau)
- 婚姻登记员 (Marriage Registrar): 王燕 (Wang Yan) — handwritten signature
- Gray embossed seal also visible on right page

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---
type: certificate
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-08
source: xuewei_marriage_cert_2.jpeg
---
# Xuewei Marriage Certificate - Page 2 (Chinese Original)
> Note: This image is identical to page 2 of `marriage_cert.pdf` (Xuewei's copy). It shows the details page of the marriage certificate.
## Upper Section
| Field (Chinese) | Value |
|---|---|
| 持证人 (Certificate Holder) | 姜薛伟 |
| 登记日期 (Registration Date) | 2016年08月08日 |
| 结婚证字号 (Marriage Certificate No.) | J370105-2016-002657 |
| 备注 (Annotation) | (blank) |
- Couple photo with official stamp overlay (woman on left, man on right)
## Lower Section
**Wife:**
| Field | Value |
|---|---|
| 姓名 (Name) | 姜薛伟 |
| 性别 (Gender) | 女 (Female) |
| 国籍 (Nationality) | 中国 (China) |
| 出生日期 (Date of Birth) | 1993年03月13日 |
| 身份证件号 (ID Number) | 370105199303130825 |
**Husband:**
| Field | Value |
|---|---|
| 姓名 (Name) | 陆彦忻 |
| 性别 (Gender) | 男 (Male) |
| 国籍 (Nationality) | 中国 (China) |
| 出生日期 (Date of Birth) | 1989年10月17日 |
| 身份证件号 (ID Number) | 44018119891017001X |
- Footer: **M Z H B J Z H**

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---
type: certificate
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-08
source: xuewei_marriage_cert_3.jpeg
---
# Xuewei Marriage Certificate - Page 3 (Chinese Original)
> Note: This image is identical to page 3 of `marriage_cert.pdf` (Xuewei's copy). It shows the back cover spread of the marriage certificate booklet.
## Left Page
婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。
(The marriage law prescribes that the man and the woman who want to get married must go in person to the marriage registration office to register the marriage. Those who conform to the provisions of this law shall be registered and issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificate.)
## Right Page
- Decorative floral medallion
- Serial Number: **No 0341002847**

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---
type: translation
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-13
source: xuewei_marriage_trans.pdf
---
# Xuewei Marriage Certificate Translation (PDF - 3 Pages)
> Note: This 3-page PDF contains the same content as `xuewei_marriage_trans_1.jpeg`, `xuewei_marriage_trans_2.jpeg`, and `xuewei_marriage_trans_3.jpeg`. It is also identical to pages 4-6 of `marriage_cert.pdf`.
## Page 1: 结婚证第一页 / Page 1
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang
## Page 2: 结婚证第二页 / Page 2
| Chinese | English |
|---|---|
| 持证人: 姜薛伟 | Certificate Holder: Xuewei Jiang |
| 登记日期: 2016年08月08日 | Registration Date: August. 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1 (Wife):**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
**Person 2 (Husband):**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |
## Page 3: 结婚证第三页 / Page 3
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
**Signed by:** Xuewei Jiang (signature: X [cursive])
**Notarization:**
- State of Texas, County of Travis
- This instrument was acknowledged before me on the 13th day of August, 2016
- by Xuewei Jiang
- Notary Public (signed)
- Notary Stamp: LUIS BARRERA, Notary Public, State of Texas, My Commission Expires August 19, 2019

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---
type: translation
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-08
source: xuewei_marriage_trans_1.jpeg
---
# Xuewei Marriage Certificate Translation - Page 1
> Note: This image is identical in content to page 4 of `marriage_cert.pdf`.
## 结婚证第一页 / Page 1
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang

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---
type: translation
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-08
source: xuewei_marriage_trans_2.jpeg
---
# Xuewei Marriage Certificate Translation - Page 2
> Note: This image is identical in content to page 5 of `marriage_cert.pdf`.
## 结婚证第二页 / Page 2
| Chinese | English |
|---|---|
| 持证人: 姜薛伟 | Certificate Holder: Xuewei Jiang |
| 登记日期: 2016年08月08日 | Registration Date: August. 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1 (Wife):**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
**Person 2 (Husband):**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |

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---
type: translation
category: marriage
person:
- Jiang Xuewei
- Lu Yanxin
date: 2016-08-13
source: xuewei_marriage_trans_3.jpeg
---
# Xuewei Marriage Certificate Translation - Page 3
> Note: This image is identical in content to page 6 of `marriage_cert.pdf`.
## 结婚证第三页 / Page 3
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
**Signed by:** Xuewei Jiang (signature: X [cursive])
**Notarization:**
- State of Texas, County of Travis
- This instrument was acknowledged before me on the 13th day of August, 2016
- by Xuewei Jiang
- Notary Public (signed)
- Notary Stamp: LUIS BARRERA, Notary Public, State of Texas, My Commission Expires August 19, 2019

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---
type: certificate
category: marriage
person:
- Lu Yanxin
- Jiang Xuewei
date: 2016-08-08
source: yanxin_marriage_cert.pdf
---
# Yanxin Marriage Certificate (PDF - 3 Pages, Chinese Original Scans)
> Note: This 3-page PDF contains the same scanned images as `yanxin_marriage_cert_1.jpeg`, `yanxin_marriage_cert_2.jpeg`, and `yanxin_marriage_cert_3.jpeg`. It is also identical to pages 7-9 of `marriage_cert.pdf`.
## Page 1: Inner Cover Spread
**Left Page:**
- Seal: 中华人民共和国民政部 婚姻证 (Ministry of Civil Affairs of the People's Republic of China - Marriage Certificate) — national emblem seal in red
- Footer: 中华人民共和国民政部监制
**Right Page:**
- Text: 结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。
- 登记机关: Red seal — 济南市天桥区区民政局婚姻登记专用章
- 婚姻登记员: 王燕 (Wang Yan) — handwritten signature
- Gray embossed seal also visible
## Page 2: Back Cover Spread
**Left Page:**
- 婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。
**Right Page:**
- Decorative floral medallion
- Serial Number: **No 0341002846**
## Page 3: Certificate Details Page
**Upper Section:**
| Field (Chinese) | Value |
|---|---|
| 持证人 (Certificate Holder) | 陆彦忻 |
| 登记日期 (Registration Date) | 2016年08月08日 |
| 结婚证字号 (Marriage Certificate No.) | J370105-2016-002657 |
| 备注 (Annotation) | (blank) |
- Couple photo with official stamp overlay
**Lower Section - Husband:**
| Field | Value |
|---|---|
| 姓名 (Name) | 陆彦忻 |
| 性别 (Gender) | 男 (Male) |
| 国籍 (Nationality) | 中国 (China) |
| 出生日期 (Date of Birth) | 1989年10月17日 |
| 身份证件号 (ID Number) | 44018119891017001X |
**Lower Section - Wife:**
| Field | Value |
|---|---|
| 姓名 (Name) | 姜薛伟 |
| 性别 (Gender) | 女 (Female) |
| 国籍 (Nationality) | 中国 (China) |
| 出生日期 (Date of Birth) | 1993年03月13日 |
| 身份证件号 (ID Number) | 370105199303130825 |
- Footer: **M Z H B J Z H**

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---
type: certificate
category: marriage
person:
- Lu Yanxin
- Jiang Xuewei
date: 2016-08-08
source: yanxin_marriage_cert_1.jpeg
---
# Yanxin Marriage Certificate - Page 1 (Chinese Original)
> Note: This image is identical to page 7 of `marriage_cert.pdf` (Yanxin's copy). It shows the inner cover spread of the marriage certificate booklet.
## Left Page
- Seal: 中华人民共和国民政部 婚姻证 (Ministry of Civil Affairs of the People's Republic of China - Marriage Certificate) — national emblem seal in red
- Footer: 中华人民共和国民政部监制 (Supervised by the Ministry of Civil Affairs of the People's Republic of China)
## Right Page
- Text: 结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。
- (The marriage application conforms to the Marriage Law of the People's Republic of China; registration is hereby granted and this certificate is issued.)
- 登记机关 (Registration Office): Red seal — 济南市天桥区区民政局婚姻登记专用章 (Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau)
- 婚姻登记员 (Marriage Registrar): 王燕 (Wang Yan) — handwritten signature
- Gray embossed seal also visible on right page

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---
type: certificate
category: marriage
person:
- Lu Yanxin
- Jiang Xuewei
date: 2016-08-08
source: yanxin_marriage_cert_2.jpeg
---
# Yanxin Marriage Certificate - Page 2 (Chinese Original)
> Note: This image is identical to page 8 of `marriage_cert.pdf` (Yanxin's copy). It shows the back cover spread of the marriage certificate booklet.
## Left Page
婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。
(The marriage law prescribes that the man and the woman who want to get married must go in person to the marriage registration office to register the marriage. Those who conform to the provisions of this law shall be registered and issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificate.)
## Right Page
- Decorative floral medallion
- Serial Number: **No 0341002846**

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---
type: certificate
category: marriage
person:
- Lu Yanxin
- Jiang Xuewei
date: 2016-08-08
source: yanxin_marriage_cert_3.jpeg
---
# Yanxin Marriage Certificate - Page 3 (Chinese Original)
> Note: This image is identical to page 9 of `marriage_cert.pdf` (Yanxin's copy). It shows the details page of the marriage certificate.
## Upper Section
| Field (Chinese) | Value |
|---|---|
| 持证人 (Certificate Holder) | 陆彦忻 |
| 登记日期 (Registration Date) | 2016年08月08日 |
| 结婚证字号 (Marriage Certificate No.) | J370105-2016-002657 |
| 备注 (Annotation) | (blank) |
- Couple photo with official stamp overlay (woman on left, man on right)
## Lower Section
**Husband:**
| Field | Value |
|---|---|
| 姓名 (Name) | 陆彦忻 |
| 性别 (Gender) | 男 (Male) |
| 国籍 (Nationality) | 中国 (China) |
| 出生日期 (Date of Birth) | 1989年10月17日 |
| 身份证件号 (ID Number) | 44018119891017001X |
**Wife:**
| Field | Value |
|---|---|
| 姓名 (Name) | 姜薛伟 |
| 性别 (Gender) | 女 (Female) |
| 国籍 (Nationality) | 中国 (China) |
| 出生日期 (Date of Birth) | 1993年03月13日 |
| 身份证件号 (ID Number) | 370105199303130825 |
- Footer: **M Z H B J Z H**

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---
type: translation
category: marriage
person:
- Lu Yanxin
- Jiang Xuewei
date: 2016-08-13
source: yanxin_marriage_trans.pdf
---
# Yanxin Marriage Certificate Translation (PDF - 3 Pages)
> Note: This 3-page PDF contains the same content as `yanxin_marriage_trans_1.jpeg`, `yanxin_marriage_trans_2.jpeg`, and `yanxin_marriage_trans_3.jpeg`. It is also identical to pages 10-12 of `marriage_cert.pdf`.
## Page 1: 结婚证第一页 / Page 1
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang
## Page 2: 结婚证第二页 / Page 2
| Chinese | English |
|---|---|
| 持证人: 陆彦忻 | Certificate Holder: Yanxin Lu |
| 登记日期: 2016年08月08日 | Registration Date: August. 8th, 2016 |
| 结婚证字号: J370105-2016-002657 | Marriage Certificate No.: J370105-2016-002657 |
| 备注 | Annotation |
**Person 1 (Husband):**
| Chinese | English |
|---|---|
| 姓名: 陆彦忻 | Name: Yanxin Lu |
| 性别: 男 | Gender: Male |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1989年10月17日 | Birth Date: October. 17th, 1989 |
| 身份证号码: 44018119891017001X | ID Number: 44018119891017001X |
**Person 2 (Wife):**
| Chinese | English |
|---|---|
| 姓名: 姜薛伟 | Name: Xuewei Jiang |
| 性别: 女 | Gender: Female |
| 国籍: 中国 | Nationality: People's Republic of China |
| 出生日期: 1993年3月13日 | Birth Date: March. 13th, 1993 |
| 身份证号码: 370105199303130825 | ID Number: 370105199303130825 |
## Page 3: 结婚证第三页 / Page 3
**婚姻法规定，要求结婚的男女双方必须亲自到婚姻登记机关进行结婚登记。符合本法规定的，予以登记，发给结婚证。取得结婚证，即确立夫妻关系。**
The marriage law has prescribed that the man and the woman who want to get married must go to the marriage registration office to make a marriage registration. In line with the provisions of this law, be registered, issued a marriage certificate. The husband-and-wife relationship shall be established as soon as they acquire the marriage certificates.
**Signed by:** Yanxin Lu (signature: X [cursive])
**Notarization:**
- State of Texas, County of Travis
- This instrument was acknowledged before me on the 13th day of August, 2016
- by Yanxin Lu
- Notary Public (signed)
- Notary Stamp: LUIS BARRERA, Notary Public, State of Texas, My Commission Expires August 19, 2019

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---
type: translation
category: marriage
person:
- Lu Yanxin
- Jiang Xuewei
date: 2016-08-08
source: yanxin_marriage_trans_1.jpeg
---
# Yanxin Marriage Certificate Translation - Page 1
> Note: This image is identical in content to page 10 of `marriage_cert.pdf`.
## 结婚证第一页 / Page 1
**中华人民共和国民政部结婚证印章**
Seal for Marriage Certificate of the ministry of Civil Affairs of People's Republic of China
**中华人民共和国民政部监制**
The manufacture was supervised by the Ministry of Civil Affairs of People's Republic of China
**结婚申请，符合《中华人民共和国婚姻法》规定，予以登记，发给此证。**
This application conforms to the Marriage Law of the People's Republic of China. We hereby give them the permission to register and issue this marriage certificate.
**登记机关**
Registration Office
**济南市天桥区区民政局婚姻登记专用章**
Special Seal for Marriage Register of Tianqiao District, Jinan Civil Affairs Bureau
**婚姻登记员: 王燕**
Marriage Register: Yan Wang

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