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,"., Ce~ DIS"",,- O()OI. SlGUIIO 8£MnagS pi R£QAYAOO!'otQ PQSL, WJtO .2 ~ UC' I If QUOAD '.,"'~ ~ \ t..~...~ l2A2Y'~'1:., A$£Gtr.~ +. k., Ii Pre k. C ,USC' POo.2t:'co .( I{ 'nJO OE P.1QAMC CJITP C rr»: Graves !" 1 M>M":.I c:=:J ,.tQUl •• ASlGUAAOOPA...oPAL. .I..,,~ "10 "';;0.. cc. ~~ ... .) 1 <:- ASlGUWIC) AffC'-DO ( .• cc.__ ~-:--:- IIm,AM.",'l r-J.~.-:~._' .... k a,C;:.~ cc. " o~I~ OOCUMENTOS ANEXOS ~ POR MUERTE SI ES POR VCEQUIAS kltocOC!. de Ced,';!f;6MC..two prlncip~1 ~ f«N" DII1F".Al de pstOS '\jt\.,.t"iOI ,q stro(Iv" de c!efunciOn 0 fctoCDDt. llJUflCc:adJ. ~ '4IIJ:f'O CI'fII" _\l'ld6fto 'ctcCII'- ~ • ~''''LI~uIJla'Arl ~ "COCCc::i .. dI:Io.er .... Ot ~CI Of lOS~ G.etI'!:!S er-~ C4 II tx.a:a. ftCICI"OOJl. tort. dItIc:a comp'.,-. 0 1dII" ft'''''U!!h CO" ~ ;. cW'IIoor'l~ ._. F ..... l:tlUl,...".. .....WN6 c::::J ~'p$tf"O t1'~ CIImr.::l"IOI'IIo ., ,*,","I"COI fIIUII ~ or '0 UIIlIIOO DI"Ir'IQIIia. = CefQ1Ic:Io(lt\ d. I tIsc.,a r4C1'OC!N ~ His=ori.l aNa """'MIITIIIf'tO ee adj..,., Oc,,,,,,,,.nt:01 QI.I. 'PI"l.l-eo. al4ld eM CItOI>~&t1o. ~Irlo 0 ooteedOt (.t$O dotIIe C .. QOI'! ~ '-eJ'l de pi ddI~ SIItPGI a.- _ Cooar4t'CDI .... prtXIicarto .~ caoi4lC! eM art'~.MtO 0 ~1tOOt tI ..... ~ c::J f c: :OP' de ~ ctdIoi. del t.. 1Je::SOa L ...... fea.:.n oe p.s ~'l)apdl Cl 51(5 I'O~ 'CAPAOOAOTY' 0 [,qWE[l.\~B Gv.,<s c::::::J .... :_. »~ Ot( ... -;1140 c::::J _tacnOlPS -- 0lI>O" c:::J Hdlor...dlfIQ c:J C. ~c.tti6" de ,,..... ow c::J FotOC:OPI. del, pOI tl Is.., 'AP] c:::J Ooclol'ntt'ltO'~ lO'utbe c:.lld.d. prop!~no. Cll'l'etldataJ'ic o PO'ftdOt .1., ., dob. cl.lp6n) Cl Otro' _ O.t.VAO~tS ~---------------

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Page 1: ! 1 r-J.~.-:~. · I.sl"~~ OcIw (dO ~.,,, OS 1(;'_. I 2.000,PG.--IAS(JOCLc.u.t $.A ".s 8.af1JIMI",lu 10 10.11'1 f,2·'2. 10030 1~J.l. 2n.'K,'f DIbIcIro .llal«lm

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SlGUIIO

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• OOCUMENTOS ANEXOS

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POR MUERTE SI ESPORVCEQUIASkltocOC!. de Ced,';!f;6MC..two prlncip~1 ~ f«N" DII1F".Al de pstOS '\jt\.,.t"iOI,q stro(Iv" de c!efunciOn 0 fctoCDDt. llJUflCc:adJ. ~ '4IIJ:f'O CI'fII" _\l'ld6fto 'ctcCII'-

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O.t.VAO~tS ~---------------

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. .REP~LICA DE COLOMBIAIDEtmFlCACION peRSONAL

CEOUI.A"" CI~I"22.671.411

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REI'UULICA OF. COI,OMUIAOHl'ARTAMllrrrO ORI.ATLANTICO

IRINA MARGAlUTA ROMERO GAMAIUtA£L SI)SCRl'rO NOTARJO ONICO (e) OEL CiJlCI)LO OE

SANTO TOMA$-A 1'LA ......ICO

DECLARACIONJURADAA'tallo,460

En el Munkiplo de Santo TomAs. cabooora Notarial del mlamo nol'nbro, OoP,"amento del Atl~ntlco,RepubrlCa de Colombia ... 'os 01 dills dol mttS do eenere do Doe MI cetcece (2014). ente mi I~AMARGARITAROMERO GAIWIRA, NOlo"" (lnleo (E) do .". CI,,,,,10 NOlo,lel, comp.recl6 MARIAISABELMORAlES, mayor de eded, vecino{a) de Pamer do Varale, OepllftBmento do' AUl'tntloo. portador(a) dela C6dula de eludedanla N0.22~5""'6xpedida en Palm.r do Varoll (AU.), Qulon b3jo 18groved.ddel Juramenlo Y (Gnlendo en eventa 01 Deerell) 1S57 do Junlo de 1989 manifo,'I). PRJMERO:Ouo comodeclatantes afirTnan no .ener nlnguna cia sa de impedlmonto Iogal I) moml paro fond" ostasdeclIradones juramentldal, tal eU11e1 prOllan bajo au onlcn y enle(8 retponsoblldad. SEGUNDO:QIJe eeneeen la respons.bilidad que lmpb Juro( en falso con fomlO al e6digo Ponal lERCERO: QueIH dec.l'Kione. que ,qu( Ie mden vers.,n IObr. hecho. do tot eUDlos cl-anpienlll ro y tosUmonlo enf"N;6n que ae, conSUl petlonamonte. CUARTO: Me llilmo y mo kSonttOcocomo 'llano dicho y reskfo en10C.'lo 12£1 No,IO-72 ~ Munro.,,,, do Polm" do VI"''', oeplr1omonlo dol AU'nllco, Ropubl~. doColomblo, QUINTO: Docloro bolo 10g".odld dol )U"",""IO, quo conocl do Vlsll, 11'310Ycomunlcoclon.1 senor JACINTO CAAON CUrftvA., qulen en vld. I' Idontiflcaba con .. C6dula de CiudadanlaNo.468.270. '1 el por ese tf1lto y comunlcacl()n que del tuvo M quo .tt y me con ... que en 01momenta de IY ',lI'>clmiento 01di, ~ 01 do IgOltO do 2014, oro de OItido cl¥'1calado con la lenora""HUElA VICTORIAFOIITAlYO OE CAlioN, ldonlJllcodl con 10 ~uta d. Cludadlnll No,22.871,411expodld. en Son .. T_ (AII.~ Y 'enlo cinco (05) hjot ROCIO oa CARMEN CAAoN FONTAlVO,C.C.22.I7lAOS. JORGE AlBERTO CAIloH FONTAlVO, C C n124.!1t2; BlNICA CECIlIA CARON FONTAlVO,C,C.2U75~ AHGEl IlARIA cAlioN FOMTAlVO, C C nJI3.72f, y EDWIN JACINTO CAAoH FONTAlVO,C,C7U14.727. htoa proctNdos dentlO dot Matrmonio. qu1enol eran 10. unieol hljol. ya que no teniaOtrol,... matrimonla .. nI.xnmltrmonll.l. I'll edOptNOi. "namen'e)Os antel mencionados. II~u.1 que no exb!en 0Ct0I hijot benordenol,. que los Intel mencioOidoa. todD esto M do mI_nlo yo quo W'f Imlgo do ta l.mIIIa Ca_ FOIItolllO,

Ruego II MI\o( Hotatlo. URI vex ton'OcSaI lea dedirKionea me dovuelva 01 ortJrsal par. eldligenelamlenlo '-"" LAPIt£SD<Tt DECLAllAl:I(JorRII!N.IZA COlIDESTtiO '" LA,,,,,re IfTt._La Notaril Ona de Santo Tom6I no I'HPOnd. par e1 QOnIellldo 61 ... manile5WCiona de V<Nntad._da en .. to _. De_ No_tal $10,.00 rv" $1,66<: R.. _n No.068 de 08d. Enero de 2014ElDEC~

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