RENTAL APPLICATION

PRIMARY APPLICANT

Full Name: Samir Riascos Eduardo Castro Social Security Number: 548521 Date of Birth: April 2, 1995 Work Phone Number: 2641464 Home Phone Number: 3213637427 E-Mail: samireduardo222@hotmail.com

Spouse's Full Name: maria victoria fields Social Security Number: 24565 Date of Birth: August 3, 1996 Work Phone Number: 2641464 Home Phone Number: 3213637427 E-Mail: mariavistoria222@hotmail.com

RENTAL HISTORY PRIMARY APPLICANT'S INFORMATION

Current Address: the 8th street n 12-10 City: Florida State: Zip Cauca Valley: 2465554 Date In: November 14, 2010 Date Out: October 14, 2013 Rent Amount: 500,000 Landlord's Full Name: Fabian Castro Landlord'S Phone Number: 263 8538 Landlord's E-Mail: fabiancastr6@hotmail.com

Reasons For Moving: Personal Problems

Previous Address: Calle 9 No. 14-15

City :: Florida Valley State: Zip Huila: 12548574 Date In: November 14, 2005 Date Out: November 13, 2010 Rent Amount: 300,000 Landlord's Full Name: clear Cuaran Landlord'S Phone Number: 2621514 Landlord's E-Mail:

Reasons For Moving: Better housing

APPLICANTS THAT WILL LIVE IN THE PROPERTY

Full Name: Samir Riascos Eduardo Castro Age: 18 Relationship: Married Full Name: Maria Victoria Campos Age: 17 Relationship: Married Full Name: Camilo Riascos Campos Age: 5 Relationship: son Full Name: sally fields Riascos Age: 2 Relationship: daughter

RENTAL APPLICATION

PRIMARY APPLICANT

Full Name: Samir Eduardo Riascos Castro Social Security Number: 548521 Date of Birth: 2 abril 1995

Work Phone Number: 2641464 Home Phone Number: 3213637427 E-Mail: samireduardo222@hotmail.com

Spouses Full Name: maria victoria campos Social Security Number: 24565 Date of Birth: 3 agosto 1996 Work Phone Number: 2641464 Home Phone Number: 3213637427 E-Mail: mariavistoria222@hotmail.com

PRIMARY APPLICANTS RENTAL HISTORY INFORMATION

Current Address: calle 8a n 12-10 City: florida State: valle del cauca Zip: 2465554 Date Out: 14 de octubre 2013 Rent Amount: 500.000

Date In: 14 de noviembre del 2010 Landlords Full Name: Fabian Castro

LandlordS Phone Number: 263 8538 Landlords E-Mail: fabiancastr6@hotmail.com

Reasons For Moving: Problemas personales

Previous Address: calle 9 N 14-15

City:

: Florida valle State: Valle del cauca

Zip:12548574 Rent Amount: 300.000

Date In:14 de noviembre 2005 Date Out: 13 de noviembre 2010 Landlords Full Name: clara cuaran LandlordS Phone Number: 2621514 Landlords E-Mail:

Reasons For Moving: Mejor vivienda

APPLICANTS THAT WILL LIVE IN THE PROPERTY

Full Name: Samir Eduardo Riascos Castro Full Name: Maria Victoria Campos Full Name: Camilo Riascos Campos Full Name: sally Riascos campos

Age: 18

Relationship: Casado

Age: 17 Relationship: Casada Age: 5 Relationship:hijo Age: 2 Relationship: hija