Kennedy Ellesmere Plaza
880 Ellesmere Rd. Unit # 310 Scarborough, ON M1P 2W6
Tel: 416-444-1271

Proof of Conversion to Islam


Date ________________________________


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


Signature of Masjid Imam or Administrator


Male Family member's Signature
First Witness