LXXXX P 027

Number: 14 CIVIL REGISTRY OF: GENERAL CONSULATE OF SPAIN

CARACAS, VENEZUELA

OPTION: REGISTRANT’S INFORMATION

The undersigned
obtained the Name: SUSAN -
Spanish nationality First Last name: SOSA-
of origin on Second last name: SANCHEZ-
8-19-2010 Sex: FEMALE
and on the civil Hour of birth: FIVE WITH TEN
vicinity (illegible) Day: SIXTEEN Month: JULY
by virtue of the 7th Year: NINETEEN SEVENTY-FOUR
Additional Provision Place: CARACAS- VENEZUELA
of the Law. 52/2007, Father: JUAN JESUS SOSA Y SEIJAS
without renouncing son of: JOSE RAFAEL
to previous and of: BLANCA MARGARITA
nationality. born in: MADRID
Caracas, 10-4-2010 on: the 17th of NOVEMBER of 1951
Marital Status: MARRIED Nationality: VENEZUELAN
(illegible signature) Residency: VENEZUELA Profession: ----------
Bernabe Aguilar Arigo MOTHER: ILIANA SANCHEZ Y RIBAS
General Deputy Consul Daughter of: HUMBERTO
And of: ALBINA
Born in: CARACAS-VENEZUELA
On: the 13th of MARCH 1900
Marital status: MARRIED Nationality: VENEZUELAN
residency: CARACAS,- VENEZUELA Profession: ----------
PARENT’S MATRIMONY: Certification Document
Celebration day: 7 Month: NOVEMBER Year: 1972
Place: CARACAS- VENEZUELA
Volume: ---------- Page: ----------
Document presented: ----------
Affiant: SUSAN MENDEZ
Declares as: (illegible)
Residency: CARACAS- VENEZUELA
ANNOTATIONS: (NONE)
IN CHARGE: Bernabe Aguilar Arigo - General Deputy Consul
At: 1:05 of OCTOBER the 4th of TWO THOUSAND AND TEN

(illegible signature)
I CERTIFY. That this literal certification contains the full reproduction of the corresponding entry in Volume
965 of Section I of this Civil Registry and is issued for matters in which it is necessary to prove parentage,
without it being admissible for other purposes (Articles 26 and 30 of the Civil Registry Regulations)
THE ONE IN CHARGE
OCT. (illegible), 2010

(ILLEGIBLE SIGNATURE)
Bernabe Aguilar Arigo
General Deputy Consul