MEXICO
CIVIL REGISTRY
BIRTH CERTIFICATE
IN THE NAME OF THE STATE OF VERACRUZ DE IGNACIO DE LA LLAVE AND AS THE OFFICIAL 1 OF THE CIVIL REGISTRY, I DO
HEREBY CERTIFY THAT THIS BIRTH CERTIFICATE HOLDS TRUTH TO THE GIVEN INFORMATON RECORDED FROM THE ORIGINAL
BOOK.
MUNINIPALITY: JOSE AZUETA
DATE OF REGISTRY: DAY: 23 MONTH: 11 YEAR: 1990 BOOK: 04 CERTIFICATE NO.: -7777
REGISTRANT PERSONAL ID: 301690190000000
REGISTRANT INFORMATION
NAME: ANA
FIRST SURNAME: BARRRIENTOS
SECOND SURNAME: BLANCO
DATE OF BIRTH: SEPTEMBER 24, 1990 TIME: 17:30 SEX: FEMALE
PLACE OF BIRTH: VERACRUZ
MUNICIPALITY OF BIRTH: VERACRUZ
STATE OF BIRTH: VERACRUZ
CONDITION OF BIRTH: ALIVE APPEARED BEFORE OFFICE: BOTH PARENTS
PARENTS’S INFORMATION
FATHER’S NAME: JUAN MOTHE’S NAME: ANA
FIRST SURNAME: BARRIETOS FIRST SURNAME: BLANCO
SECOND SURNAME: CRUZ SECOND SURNAME: RAMIREZ
AGE:23 NATIONALITY: MEXICAN AGE: 24 NATIONALITY: MEXICAN
I CERTIFY THAT THIS CERTIFICATE IS ISSUED IN JOSE AZUETA IN THE STATE OF VERACRUZ DE IGNACIO DE LA LLAVE ON MARCH
22, 2011
[ILLEGIABLE SIGNATURE]
LIC. FELIPE BERNARDO ESPINOZA ZUÑIGA
CIVIL REGISTRY OFFICIAL
ADMIN [ILLEGIABLE SIGNATURE] [SEAL]
[WATERMARK SERIAL NUMBER]-3718360