REPUBLIC OF ECUADOR

General Department of Civil Registry, Identification, and Documentation

usd.600

Birth certificate Volume 2 Page 5, Record 864

In Luis Cordero province of Caar today twenty-ninth of August of the year

one thousand nine hundred and seventy five. The undersigned, head of civil
registry, extends the present record of the birth of .
NAME: Carmita Isabel LAST NAME: Cabrera Perez
SEX: Female DATE OF BIRTH: August 15, 1945
PLACE: Luis Cordero CANTON: Azogues PROVINCE: Caar
FATHER'S NAME AND SURNAME: Jose Adolfo Cabrera Saico
NATIONALITY: Ecuadorian MARITAL STATUS: Married
IDENTITY CARD No. 03-0033218
MOTHERS NAME AND SURNAME: Carmen Amelia Perez Campoverde
NATIONALITY: Ecuadorian MARITAL STATUS: Married
IDENTITY CARD No. 03-0035488
REQUEST THIS INSCRIPTION: The father of the inscribed IDENTITY CARD
No.
YEAR OF AGE: Twenty five OCCUPATION: Farmer
Also records indicated that it is the third childbirth.
OBERVATIONS

Stating the name and surnames of the parents for being married, this has
been proven with the marriage certificate that is filed in this office.
Illegible signature and official seal

AFFIDAVIT

I, Luis Alcivar hereby certify that I am competent enough to translate from English to Spanish and
that I have translated the forgoing document from Spanish to English and that the translation is
accurate to the best of my knowledge.
State of New York
County of New York
Sworn to before me this 22 day of February, 2017

________________________ ____________________
Notary Signature