REPUBLIC OF PERU Bar code: 03359531 Logo: RENIEC Surnames: Olivera Gonzales Names: Sergio Rodrigo Date of birth: 09/20/1983 Declarant identified by: L-E.4188524 Bar code: 1000358257 Population births San Isidro District Council Registries of civil status Lima - Peru Year 1983 - Book 8 Birth Certificate: 2153…………………………………………………………………………………… Names and surnames: Sergio Rodrigo ……………Olivera Gonzales …………………….. Place of Birth: Clinic Santa Isabel Date of Birth: Hour: 12:15 Day: 20 Month: October of 1983 Sex: Masculine…………………………………………………………………………………… Father: Sergio Augusto Olivera Sedo…Age: 37……………………………………………………… Profession and Occupation: Engineer Natural of : Lima - Peru Nationality : Peruvienne……. Domiciled at: Surquillo - San Borja - Bozzoli 158…………………………………………………….. Mother: Maria Patricia Gonzalez de Olivera…Age 22 Profession and Occupation: Housekeeper Natural of: Lima - Peru….Nationality: Peruvienne ……………Domiciled at: the same property Declarant: The undersigned father ……Age........Profession and Occupation............... Civil Status.. Natural of......... .Nationality......... Domiciled at........................................................... This certificate is hereby issued In San Isidro at …………...9:30………….on the day ........................ .27………….. September From 1983................................................................................................................................. That undersigned: The declarant, the Registrar and the Section Chief. SIGN (declarant) SIGN (registrant) SIGN (authorized official) Stamp number: 03359531 Administrative Rectification ……………………………………………………………………………………………………………. Registry Processing and Cleansing Manager Deputy Manager of processing and purification of RRCCs Directive 073-GDPR/003 - Head Resolution 344-2007- JEF/RENIEC Date: 04/04/2007 Omission of signature, seal, stamp and signature of the civil registrar in the body of the record or in the textual or marginal annotations of the record. Quintana Avila Ines Ana Qualifier of Titles 13/10/2007 Logo (ISO) Logo (RENIEC) It is certified that the present is a true copy of the original one that is in the file of the RENIEC Lima 07/31/2023 Signature (RENIEC certifier) Claudia Lisset Tong Rosso Validation Code (visit http://www.RENIEC.GOB .PE) 04518690 1000358257 07/31/2023 15:44:44
