1+1

Citizenship and Immigration Canada

Citoyennete et Immigration Canada PROTE

IMMIGRATION
r.V.

RECORD OF LANDING FICHE RELATIVE AU DROIT D'ETABLISSEMENT

,s QE LINE FOlq RpIPLI

X003646602

WHEN COMPLETED

PERMANENT RESIDENT STATUS MAY BE CHECKED WITH IMMIGRATION CANADA LE DROIT D'ETABLISSEMENT PEUT ETRE VERIFIE AUPRES D'IMMIGRATION CANADA

IMMIGRANT IDENTIFICATION
2. Surname - Nom de famille

IDENTIFICATION DE L'/MMIGRANT
3. Given Names Prenoms

3868-

ESPANO
4. Name Flag

- /ndicateur du nom - Pays de naissance

I
5. Date of Birth Date de naissance

SHYR ILL BES I TE

6. Place of Birth

D -J

Y-A

- Lieu de naissance
9. Marital Status

19

06
8. Sex

1975

7. Country of Birth

PHIL I PP I PH I L 1PP I PHILIPPI

227
227

- srt MALE - Passeport n

1

-,Ktt .

51 feiL E

10. Citizen of Citoyen de

11. Passport No

Valid Until

GG484064

- Valide jusqu'au ..

12. 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

_ 14/03/2006

PRINCIPAL
h - Date de naissance Relationship Lien de parente

14. Accompanying Family Members

- Membres de la famille qui accompagnent l'immigrant Name - Nom '''''''''''''''''TrePt nOrit -atzepeini, and Ci tyPnne , F
irnm:qration Canada trrmigration Canad a:

THE HOLDER IS NO _iNGER A PERMANENT RESIDENT ".:;?,_E NE ST PLUS .._.... ' PERMANENT ,

, . . ., ,_

rwegermarasemse.,

Have you any dependants other than those listed above? Outre celles qui soot mentionnees ci-dessus, avez-vous d'autres personnes a votre charge? 15. Full Name, Address and Relationship of Person willing to assist

Al

p 7,4. . .__

- Nom et adresse au long de la personne disposoe a offrir son aieetlien de parente

22

ELKPATH AVENUE 381 2

17. Mother Tongue Langue matemelle

TORONTO ONT M2L2W1

16. Intended Occupation

- Profession envisagee
6474-200

NANNIES & LIVE-IN CAREGIVERS

H I L I GAY NON

I
;)0 t3

021

I certify that the above statements are true and correct Je certifie que les renseignements ci-dessus soot exacts et veridiques
19. Imm. Cat.

Signature

Date

Y-A

ea.-1:-- 1.-t,"7 41. Carrier/Flight No. Transporteur/vo n

AO 6) -Z..

- Cat d'imm. -

I I

LC1

el 20 poea nprog. ent special 22. Years of Schooling -Annees d'etudes

L CP 14
42. Money in possession Argent en main $

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

03

23. Employment Code

- Code de l'emploi

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

25. C.L.P.R.

26. Trans. Warrant No.

IO

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

r

I
27. P.C. Number C.P. numero

227

43. Conditions of Landing Imposed Conditions d'obtention du droit d'etablissement imposees

IC I

I,

N du bon de transp.

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

Y- A

32. Date Issued Delivre le

m02

(:902

Visa Validity Validite du visa'

D-J

Y-A

44. understand these conditions conditions

- Je comprends ces
_
M
'

90
Y A

34. Office of Issue Bureau d'origine

P.S. Code Code du P.S.

CPC VEG
35. Signature of Visa Officer Signature de /'agent des visas

- 9518

i 45. Landed Dro t d tabl ssement obtenu le

3\0

iniCI'ON,
P.S. C / 60

46. AT A

SCAT BORO GH
36. PrigLa itTU
D-J

r`i

Y-A

37Recommended

- Recommande

47. Signature of d'immigration

cer- Signatur 'eler

gent

14
38. Utilities Libres 39. Remarks - Observations

05

1999

A
NOT VALID FOR TRAVEL NON VALIDE POUR LES VOYAGES
[

/
Err.

i'il 9 28 2 2 9 17 5
I

LFC .

I000440338
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 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. LE PRESENT DOCUMENT EST LA PROPRIETE DU GOUVERNEMENT DU CANADA.

1000 (CON) (01/2000) B

0-te

C 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 CITY / MUNICIPALITY 1. NAME 2. SEX

.11010

LOCAL CIVIL REGISTRY NO.

179

Legnnes
(First) (Middle)

(Last)

SHYRILL
(Place 'X' on appropriate answer) -2 Female (Name of hospital/Institution; If not in hospital, give street / barangay) --1 Male

BESITE
DATE OF BIRTH
3. (Day)

ESPANO(Month) (Year)

19

'June
(Province)

1975

4. PLACE OF BIRTH

(City / Municipality)

Cagamutan Norte Le anes

5a. TYPE OF BIRTH
x- 1 Single (Place 'X' on appropriate answer) 2 Twin _ 3 Three or more (Middle) (Last) 5b. IF MULTIPLE BIRTH CHILD WAS

Iloilo
3 Third, 4th,etc.

1 First

2 Second

6. [. MAIDEN NAME

(First)

7. NATIONALITY

, 8. RELIGION

Ketchy
9. NAME
(First) --(Middle)

Besite
(Last)

Filipina
10. NATIONALITY

Roman Catholic
11. RELIGION

Jesus

Espailo

Filipino

Romari Catholic

12. DATE AND PLACE OF MARRIAGE OF PARENTS

(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.

(SGD.) AMPARO BOLIVAR AMPARO BOLIVAR Name in print "Hilot" Title or position
Signature

Address

Leganes, Tloilo September 12, 1975

Date

14. INFORMANT
Signature Name in print,. Relationship to child Date
t\

Address

15a.PREPAIIED BY
Signattirte t IT Name inlprint Title qr Position Date

b. RECEIVED AT THE OFFICE OF THE LOCAL CIVIL REGISTRAR

Signature Name in print Title or position Date
Ilk I! DOVERO NFIRTA P. coRnovp:Rn

Se Rtgabar12,1915

CERTIFIED TRUE'COPY: _April_ 23_,_199..1._

16a. INFORMATION GIVEN IN SUPPLEMENTAL REPORT

7ki

MA. FE G FE NANDEZ Asst. *mak vil Registrar

CITY/MUNICIPALITY
17. Weight at Birth (In grams)

(Important: Informant should also provide information for items 17 to 2.S. The code boxes arc to be filled out at the Office of the Local tivil Registrar) Registration L oical Civil Registry No. Status I

_ _ _ --_ _ _ _ _ _ _ _ _
I I I 1 1
18. Birth Order of Child Ex,first, second, etc.

b. DATE WHEN INFORMATION WAS SUPPLIED

15

il, 16

20

19a. Total Number of Children Born Alive 20. Usual Occupation

0
U.

22

b. How Many children are i' now living including this birth ?

I
24

ri 1 1
= 38 i

c. How many children ' . were both alive but are nor dead?

I I I-26

22. Usual Residence (Barangay) 23, Usual Occupation

2_8 (City/Municipality .

21. Age at the time of this Birth

(Province) 24. Age at the time of this Birth

L [1 1 1 1 1
31 '33 I 41 1 1

LU

25. Attendant at Birth (Place 'X' an appropriate answer) 1 Physician _ 2 Nurse 3 Midwife Sex Date of Birth Place of Birth

4 Hilot

w
cc
I 45

44

111.1i
First

51 NAME OF CHILD
M.I.

IHIL
70 71

5 Others Mother's Father's Nationality Nationality

C71 ,

rl
56
Last

I1
57

LIE 1111 E1
58