Home search application form

Your details
First name(s): Andre
Give any other name(s) : Augusto
You were previously known by

Date of birth: 09/10/1986

Current address: Cartagena - Bolivar
Postcode:
Contact/correspondence:
Contact telephone
Numbers:
Email address:martoxpunx@sms.com
Do you experience difficulties: No
With reading or writing? :
What s your gender?: male
What is your religion?: Christian
Employment information
If you are working, please tell us: No
What do you do?:study

Your family or household

Last name

1st
Torres

2nd
Meta

3rd
Tinoco

First name

Kamile

Paula

Luis

Date of birth

02/04/85

11/08/87

07/10/82

Gender

female

female

male

Relationship

Friendly

friendly

friendly

to you (wife,
son, etc.)
Yourpresentaccommodation/circumstance
I live in atwo story house
Your house preferences
House type: a housewith garage
Number of rooms: three rooms.
Number of bathrooms:two.
Which floor:brown floor.
Public utilities: electricity, water, telephone, gas.
Location: Cartagena
Price: $60.000.000
Special requirements
Housewith two orthree bedrooms, bathrooms, a kitchen andgarage
Applicants signature
Name: Andres

Date: 19/06/2014