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E + Immigration, Refugees q and Citizenship Canada FAMILY INFORMATION [E Woricer Type of application: [7] Visitor immigration, Réfugiós et Citoyenneté Canada PROTECTED WHEN COMPLETED - B. [O otrer PAGE 1 0F 2 Complete ALL names in English and in your native language (for example, Arabic, Cyrilic, Chinese, Chinese commercial/telegraphic code, Korean, or Japanese characters). Include ALL family members even if (hey are not accompanying you. If you need more space for any section, print out an additional page containing the appropriate section, complete and submit it with your application. BEFORE YOU START, READ THE INSTRUCTION GUIDE, TYPE OR PRINT IN BLACK INK. SECTION A . Will accompany Relationship Date of bin Present address pe ndo SEE NOTE 1 (AYYY-MM-DD) (f deceased: give cily/town, country and date) ll DAVID JTMENEZ QUTRÓGA 2004-12-04 Carsera 101 No 147 C 84 Apto. 303 Int. 5 Applicant — | Country of birth: agota LOMA Marital status: COLOMBIA Present acoupalion Single STUDENT Spouse or . common-law | County of bir: oO Marital status: partnert Present ocoupation: OLGA LUCIA QUIROGA 1963-08-22 Carrera 101 No 147 C 84 Apto. 303 Int. 5 CARDENAS Meter Country or bir Bogota 110111 Colombia o Malal COLOMBIA Present occupation: Narrie JOSE GUILLERMO JIMENEZ 1962-02-10 Carrera 101 No 147 € 84 Apto. 303 Int. 5 PINEDA satmer — [Coumiy orbe Bogota 110111 Colombia a Maria! slats: LATA Present occupation: Married NOTE 4: If no spouse or common+law partner Is listed in Section A, read and sign below. Wen! E certify that | do not have a spouse or a common-law partner, Signature: PANA) món, AA Le 65.0 Moaro - bate rrrvamoo, LONZ - OR - TO SECTION B - CHILDREN (Include ALL sons and daughters, including ALL-Adopted and step-children, regardless of age or place of residence) : z Wi accompany Relationship. Date of birth Present address A SEE NOTE 2 (OVYYMM-DD) (if deceased: give city/town, country and date) o E Country of bir oO Marital status: Present occupation: Country af bir: A] Marital status: Present occupation: Country of birth: Marilal status: Present occupation: 2.0 Country of birth: oo Marital status: Present occupation: NOTE 2; If no children are listed in Section E, read and sign below. lcertify that | do not have any natural, adopted nor step-children. A T N . Moaluro Uugaa Ca coramoo, 201 - DR 10 sgnaure, Ponik Admón Q CARECE > y IMM 5645 (06-2018) E (DISPONIBLE EN FRANGAIS + IMIM 5645 F) => Canadá