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Citizenship and Immigration Canada Citoyennete et Immigration Canada

RECORD OF LANDING

FICHE RELATIVE AU DROIT D'ETABLISSEMENT

IMMIGRATION

PROTE WHEN COMPLETED

r.V. ,QE LINE FOlq RpIPLI

PERMANENT RESIDENT STATUS MAY BE CHECKED WITH IMMIGRATION CANADA

LE DROIT D'ETABLISSEMENT PEUT ETRE VERIFIE AUPRES D'IMMIGRATION CANADA

IMMIGRANT IDENTIFICATION - IDENTIFICATION DE L'/MMIGRANT

X003646602

3868-

2.

Surname - Nom de famille

ESPANO

4.

Name Flag - /ndicateur du

nom

5. Date

of Birth

Date de naissance

7.

Country

of

Birth - Pays

de

naissance PHIL I PP I

D-J

M

3. Given Names - Prenoms

SHYR ILL BES I TE

I

Y - A

6. Place of Birth - Lieu de naissance

19 06

1975

227

8. Sex - srt MALE

9. Marital Status -,Ktt.

51

feiL E

10.

12.

Citizen of - Citoyen de

PH I L 1PP I

11. Passport No - Passeport n°

227

GG484064

1 Valid Until - Valide jusqu'au

..

_

I

14/03/2006

If applicable, Country of Issue of Travel Document - S'll y a lieu, indiquer le pays de delivrance du document de voyage

13. Family Status- Situation par rapport a la famille

PHILIPPI

PRINCIPAL

I

14.

Accompanying Family Members - Membres de la famille qui accompagnent l'immigrant

Name - Nom

-

'''''''''''''''''Tre

Ci tyPnne ,F Pt

atzepeini, and

nOrit

irnm:qration Canada trrmigration

Canad a:

h - Date de naissance

THE HOLDER IS NO _iNGER A PERMANENT RESIDENT

, ,, .....

,,,_

.._....

".:;?,_E NE ST PLUS ' PERMANENT

4

rwegermarasemse. ,

Relationship - Lien de parente

1

1

Have you any dependants other than those listed above?

Outre celles qui soot mentionnees ci-dessus, avez-vous d'autres personnes a votre charge?

Alp

7,4 .....__

15.

Full Name, Address and Relationship of Person willing to assist - Nom et adresse au long de la personne disposoe a offrir son aieetlien de parente

22

ELKPATH AVENUE

TORONTO

ONT

M2L2W1

16.

Intended Occupation - Profession envisagee

NANNIES & LIVE-IN CAREGIVERS

6474-200

17.

Mother Tongue - Langue matemelle

H I L I GAY NON

I

381 2

021

I

certify that the above statements are true and correct

Je certifie que les renseignements ci-dessus soot exacts et veridiques

Signature

ea.-1:---1.-t,"7

Date

;)0

Y - A

t3 AO 6) -Z ..

19.

Imm.

Cat. - Cat d'imm.

I LC1

21.

Educ. Qual. - Certificats, diplomes, e c.

23.

Employment Code - Code de l'emploi

I

03

20

po eaelnprog.

ent special

L CP

22. Years of Schooling -Annees d'etudes 14

24. Official Lang. Ability - Conn. des longues off.

25.

C.L.P.R. = C.O.B. - D.P.R.P. = P.D.N.

I

I Or

26.

Trans. Warrant No. - N° du bon de transp.

27.

P.C. Number - C.P. numero

I

227

41.

Carrier/Flight No. Transporteur/vo n°

42. Money in possession

Argent en main

$

I

IC I

1

I

43.

Conditions of Landing Imposed

Conditions d'obtention du droit d'etablissement imposees

I,

28.

"S" Code - Code de surv.

29.

Medical File No. -Dossier medical n°

30.

Type of Case - Genre de cas

31.

Medical Validity

Validito de

l'examen medical

D-J

32.

Date

Issued

Delivre le

1

m02

(:902

Visa Validity

Validite du visa'

D-J

34.

Office of Issue - Bureau d'origine

CPC VEG

35.

Signature of Visa Officer - Signature de /'agent des visas

M

M

Y - A

Y - A

44.

I understand these conditions - Je comprends ces

conditions

P.S. Code - Code du P.S.

9518

45.

Dro t d tabl i ssement obtenu le

Landed

46. AT

A

SCAT BORO GH

90

_

M

Y - A

3\0

' iniCI'ON ,

P.S.

C

/ 60

36.

Pr igL a it TU

38.

Utilities

Libres

D - J

r`i

14 05

Y - A

1999

37Recommended - Recommande

47. Signature of

d'immigration

39.

Remarks - Observations

LFC .

NOT VALID FOR TRAVEL NON VALIDE POUR LES VOYAGES

g

o 0 cer- Signatur 'eler gent

[

A

/

i'il

9 28

2 2 9

Err.

17 5

I

SEE BACK OF COPY 1 (HOLDER) FOR WARNING AND PRIVACY STATEMENT. THIS FORM HAS BEEN ESTABLISHED BY THE MINISTER OF CITIZENSHIP AND IMMIGRATION. THIS DOCUMENT IS THE PROPERTY OF THE GOVERNMENT OF CANADA.

1MM

1000 (CON) (01/2000) B

0-te

I000440338

VOIR LAVERTISSEMENT ET LENONCE PORTANT SUR LA PROTECTION DES RENSEIGNEMENTS PERSONNELS AU VERSO DE LA COPIE I (TITULAIRE). FORMULAIRE ETABLI PAR LE MINISTRE DE LA CITOYENNETE ET DE L'IMMIGRATION.

Canada

C

LE PRESENT DOCUMENT EST LA PROPRIETE DU GOUVERNEMENT DU CANADA.

HOLDER

TITULAIRE

Municipal Form No. 102

(Revi' d 1983)

(To be accomplished in Triplicate)

REPUBLIC OF THOSHILIPPINES CERTIFICATE OF LIVE BIRTH (Fill out completely, accurately and legibly in ink or typewritten)

PROVINCE

.11010

CITY / MUNICIPALITY

1. NAME

(First)

Legnnes

SHYRILL

2.

SEX (Place 'X' on appropriate answer)

LOCAL CIVIL REGISTRY NO. 179

(Middle)

BESITE

DATE OF BIRTH

(Last)

ESPANO-

(Day) (Month)

(Year)

--1 Male

4.

PLACE OF

BIRTH

-2 Female

(Name of hospital/Institution; If not in hospital,

give street / barangay)

3.

19 — 'June

(City / Municipality)

5a. TYPE OF BIRTH

Cagamutan Norte Le anes

(Place 'X' on appropriate answer)

5b. IF MULTIPLE BIRTH CHILD WAS

1975

(Province)

Iloilo

x- 1 Single

2 Twin _ 3 Three or more

1 First

2 Second

3 Third, 4th,etc.

[.6.

MAIDEN (First) NAME

Ketchy

(Middle)

9.

NAME (First) • --(Middle)

Jesus

(Last)

Besite

(Last)

Espailo

12. DATE AND PLACE OF MARRIAGE OF PARENTS

7. NATIONALITY

Filipina

10. NATIONALITY

Filipino

, 8. RELIGION

Roman Catholic

11. RELIGION

Romari• Catholic

(Important:If not applicable,fill Affidavit of Acknowledgement at the back)

  • 13. CERTIFICATE OF ATTENDANT AT BIRTH

hereby certify that I attended the birth of thechild who was born alive at o'clock am/pm on the date stated above.

Signature (SGD.) AMPARO BOLIVAR Address Leganes, Tloilo AMPARO BOLIVAR

Name in print

Title or position

"Hilot"

Date

September 12, 1975

14.

INFORMANT

Signature

Address

Name in print,.

Relationship to child

Date

15a.PREPAIIED BY

t\

b. RECEIVED AT THE OFFICE OF THE LOCAL CIVIL REGISTRAR

 

Signattirte t IT •

Signature

Name inlprint

Name in print

Title qr Position

Title or position

Date

Date

Ilk I!

DOVERO

NFIRTA P. coRnovp:Rn

SeRtgabar12,„1915

16a. INFORMATION GIVEN IN SUPPLEMENTAL REPORT b. DATE WHEN INFORMATION WAS SUPPLIED

CERTIFIED TRUE'COPY:

_April_ 23_,_199

..

1

._

_ _ _

--_ _ _ _ _ _ _ _

_

(Important: — Informant should also provide information for items 17 to 2.S. The code boxes arc to be filled

7ki

out at the Office of the Local tivil Registrar)

MA. FE G FE NANDEZ

Asst. *mak

vil Registrar

CITY/MUNICIPALITY

 

L oi cal

Civil Registry No.

I

I 1

I

I

1

Registration

Status

15

0

U.

LU

w

cc

17. Weight at Birth

(In grams)

19a. Total Number of

Children Born

Alive

22

20. Usual Occupation

22. Usual Residence (Barangay)

23, Usual Occupation

16

il,

18. Birth Order of Child

Ex,•first, second,

etc.

b. How Many children

are

i' now

living including

this birth ?

I

24

ri 1

1

21. Age at the time

2_8

,

of this Birth

(City/Municipality

(Province)

c. How many children

' . were both alive but

are nor dead?

[

'33

1

1

=

38

i

.

24. Age at the time

of this Birth

  • 25. Attendant at Birth (Place 'X' an appropriate answer)

Sex

44

58

1 Physician _ 2 Nurse —

3 Midwife

4 Hilot

5 Others

Date of Birth

I

45

111.1i

First

Place

of Birth

IHIL

51

NAME OF CHILD

Mother's

Nationality

rl

56

I

M.I.

LIE

70

Last

1111E1

71

Father's

Nationality

I1

57

20

I

I

I--

26

L

31

1

1

1

1

I

41

1

1

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