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Submission: On March 20 via manual from GT — Scanned from DE
Submission: On March 20 via manual from GT — Scanned from DE
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<h4 style="text-align: center;"><span style="color: rgb(41, 105, 176);"><u><span style="font-family: Arial,Helvetica,sans-serif;">APERTURA CUENTA MONETARIA Y/O AHORRO </span></u></span></h4>
<p style="text-align: center;"><span style="color: rgb(41, 105, 176);"><br></span></p>
<p style="text-align: center;"><span style="color: rgb(41, 105, 176);"><span style="font-family: Arial, Helvetica, sans-serif;"><strong>Estimado cliente te damos la bienvenida al proceso de apertura de tu cuenta monetaria y/o ahorro para
pago de salario.</strong></span></span></p>
<p style="text-align: center;"><span style="color: rgb(41, 105, 176);"><span style="font-family: Arial,Helvetica,sans-serif;"><strong>Favor llenar los datos que se presentan a </strong></span><span style="background-color: initial;">
<font><strong><span style="font-family: Arial,Helvetica,sans-serif;">continuación</span></strong></font>
</span></span></p>
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<p><a href="https://www.formstack.com/admin/form/builder/4859168" title="Build"></a></p>
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<option value="ALBANIL">ALBANIL</option>
<option value="DEPENDIENTE DE MOSTRADOR">DEPENDIENTE DE MOSTRADOR</option>
<option value="INGENIERIA CIVIL">INGENIERIA CIVIL</option>
<option value="COCINERO">COCINERO</option>
<option value="BACHILLER EN CIENCIAS Y LETRAS">BACHILLER EN CIENCIAS Y LETRAS</option>
<option value="QUIMICO BIOLOGO">QUIMICO BIOLOGO</option>
<option value="MAESTRO DE EDUCACION PRIMARIA">MAESTRO DE EDUCACION PRIMARIA</option>
<option value="TAXISTA">TAXISTA</option>
<option value="SECRETARIA Y OFICINISTA">SECRETARIA Y OFICINISTA</option>
<option value="LICENCIATURA EN ADMINISTRACION PUBLICA">LICENCIATURA EN ADMINISTRACION PUBLICA</option>
<option value="MINISTRO EVANGELICO">MINISTRO EVANGELICO</option>
<option value="AGENTE DE SEGURIDAD">AGENTE DE SEGURIDAD</option>
<option value="SECRETARIA CONTADORA">SECRETARIA CONTADORA</option>
<option value="SEXTO PRIMARIA">SEXTO PRIMARIA</option>
<option value="ENFERMERA">ENFERMERA</option>
<option value="CONSULTOR">CONSULTOR</option>
<option value="AUDITOR Y CONTADOR">AUDITOR Y CONTADOR</option>
<option value="CONTADOR PUBLICO">CONTADOR PUBLICO</option>
<option value="TECNICO EN SISTEMAS">TECNICO EN SISTEMAS</option>
<option value="JEFE DE AGENCIA">JEFE DE AGENCIA</option>
<option value="ANALISTA">ANALISTA</option>
<option value="BACHILLER INDUSTRIAL">BACHILLER INDUSTRIAL</option>
<option value="TECNICO EN ADMO. DE PERSONAL">TECNICO EN ADMO. DE PERSONAL</option>
<option value="MESERO">MESERO</option>
<option value="BACHILLER EN ELECTRONICA">BACHILLER EN ELECTRONICA</option>
<option value="MISIONERO">MISIONERO</option>
<option value="INDUSTRIAL">INDUSTRIAL</option>
<option value="AGROPECUARIO">AGROPECUARIO</option>
<option value="PERITO EN ADMINISTRACION PUBLICA">PERITO EN ADMINISTRACION PUBLICA</option>
<option value="PERITO EN MERCADOTECNIA">PERITO EN MERCADOTECNIA</option>
<option value="JORNALERO">JORNALERO</option>
<option value="PERITO EN TURISMO">PERITO EN TURISMO</option>
<option value="INGENIERIA EN TELECOMUNICACIONES">INGENIERIA EN TELECOMUNICACIONES</option>
<option value="AGRICULTOR">AGRICULTOR</option>
<option value="AVICULTOR">AVICULTOR</option>
<option value="EDUCACION PRIMARIA COMPLETA">EDUCACION PRIMARIA COMPLETA</option>
<option value="GERENTE">GERENTE</option>
<option value="PROGRAMADOR">PROGRAMADOR</option>
<option value="ASESOR DE VENTAS">ASESOR DE VENTAS</option>
<option value="PILOTO AVIADOR">PILOTO AVIADOR</option>
<option value="QUIMICO FARMACEUTICO">QUIMICO FARMACEUTICO</option>
<option value="MEDICO">MEDICO</option>
<option value="MECANICO">MECANICO</option>
<option value="VETERINARIO">VETERINARIO</option>
<option value="OPERARIO DE MAQUILA">OPERARIO DE MAQUILA</option>
<option value="PROCURADOR">PROCURADOR</option>
<option value="GUARDAESPALDAS">GUARDAESPALDAS</option>
<option value="MANTENIMIENTO">MANTENIMIENTO</option>
<option value="INGENIERIA ELECTRICA">INGENIERIA ELECTRICA</option>
<option value="PERITO EN ADMINISTRACION DE EMPRESAS">PERITO EN ADMINISTRACION DE EMPRESAS</option>
<option value="INGENERIA MECANICA">INGENERIA MECANICA</option>
<option value="DIGITADOR">DIGITADOR</option>
<option value="BODEGUERO">BODEGUERO</option>
<option value="BACHILLER ELECTRICISTA">BACHILLER ELECTRICISTA</option>
<option value="LICENCIATURA EN PSICOLOGIA ESCOLAR">LICENCIATURA EN PSICOLOGIA ESCOLAR</option>
<option value="DENTISTA">DENTISTA</option>
<option value="PROFESIONAL">PROFESIONAL</option>
<option value="ZAPATERO">ZAPATERO</option>
<option value="EDUCACION BASICA COMPLETA">EDUCACION BASICA COMPLETA</option>
<option value="SECRETARIA BILINGUE">SECRETARIA BILINGUE</option>
<option value="PASTOR EVANGELICO">PASTOR EVANGELICO</option>
<option value="TECNICO EN ELECTRONICA">TECNICO EN ELECTRONICA</option>
<option value="ENCARGADO">ENCARGADO</option>
<option value="OTRA">OTRA</option>
<option value="MENSAJERO">MENSAJERO</option>
<option value="CONSTRUCTOR">CONSTRUCTOR</option>
<option value="RECEPTOR PAGADOR">RECEPTOR PAGADOR</option>
<option value="ZOOTECNISTA">ZOOTECNISTA</option>
<option value="VISITADOR MEDICO">VISITADOR MEDICO</option>
<option value="MAESTRO DE EDUCACION PRE-PRIMARIA">MAESTRO DE EDUCACION PRE-PRIMARIA</option>
<option value="CRIMINOLOGO">CRIMINOLOGO</option>
<option value="VENDEDOR RUTERO">VENDEDOR RUTERO</option>
<option value="COMERCIANTE">COMERCIANTE</option>
<option value="ABOGADO Y NOTARIO">ABOGADO Y NOTARIO</option>
<option value="AMA DE CASA">AMA DE CASA</option>
<option value="MAESTRO">MAESTRO</option>
<option value="SASTRE">SASTRE</option>
<option value="LICENCIATURA EN ADMINISTRACION DE EMPRESAS">LICENCIATURA EN ADMINISTRACION DE EMPRESAS</option>
<option value="ARQUITECTO">ARQUITECTO</option>
<option value="SECRETARIA EJECUTIVA BILINGUE">SECRETARIA EJECUTIVA BILINGUE</option>
<option value="INGENERIA INDUSTRIAL">INGENERIA INDUSTRIAL</option>
<option value="BANQUERO">BANQUERO</option>
<option value="MILITAR">MILITAR</option>
<option value="ALQUILER DE CASAS">ALQUILER DE CASAS</option>
<option value="VENDEDOR">VENDEDOR</option>
<option value="SECRETARIA">SECRETARIA</option>
<option value="SUPERVISOR">SUPERVISOR</option>
</select>
</label><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562595" for="field158562595" data-testid="field-158562595"><a id="field-anchor-158562595" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Pais de nacimiento</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div><select size="1" id="field158562595" type="select"
label="Pais de nacimiento" required="" class="StyledSelectInput-sc-1qjysc9-0 hUThWJ fsFieldSelect" name="field158562595" data-fs-field-id="158562595" data-fs-field-name="select" data-fs-field-alias="*">
<option value=""></option>
<option value="GUATEMALA">GUATEMALA</option>
<option value="AFGANISTAN">AFGANISTAN</option>
<option value="ALAND">ALAND</option>
<option value="ALBANIA">ALBANIA</option>
<option value="ALEMANIA">ALEMANIA</option>
<option value="ANDORRA">ANDORRA</option>
<option value="ANGOLA">ANGOLA</option>
<option value="ANGUILA">ANGUILA</option>
<option value="ANTÁRTIDA">ANTÁRTIDA</option>
<option value="ANTIGUA Y BARBUDA">ANTIGUA Y BARBUDA</option>
<option value="ANTILLAS NEERLANDESAS">ANTILLAS NEERLANDESAS</option>
<option value="ARABIA SAUDITA">ARABIA SAUDITA</option>
<option value="ARGELIA">ARGELIA</option>
<option value="ARGENTINA">ARGENTINA</option>
<option value="ARMENIA">ARMENIA</option>
<option value="ARUBA">ARUBA</option>
<option value="AUSTRALIA">AUSTRALIA</option>
<option value="AUSTRIA">AUSTRIA</option>
<option value="AUTORIDAD NACIONAL PALESTINA">AUTORIDAD NACIONAL PALESTINA</option>
<option value="AZERBAIYAN">AZERBAIYAN</option>
<option value="BAHAMAS">BAHAMAS</option>
<option value="BANGLADES">BANGLADES</option>
<option value="BARBADOS">BARBADOS</option>
<option value="BAREIN">BAREIN</option>
<option value="BELGICA">BELGICA</option>
<option value="BELICE">BELICE</option>
<option value="BENIN">BENIN</option>
<option value="BERMUDAS">BERMUDAS</option>
<option value="BIELORRUSIA">BIELORRUSIA</option>
<option value="BIRMANIA">BIRMANIA</option>
<option value="BOLIVIA">BOLIVIA</option>
<option value="BOSNIA Y HERZEGOVINA">BOSNIA Y HERZEGOVINA</option>
<option value="BOTSUANA">BOTSUANA</option>
<option value="BRASIL">BRASIL</option>
<option value="BRUNEI">BRUNEI</option>
<option value="BULGARIA">BULGARIA</option>
<option value="BURKINA FASO">BURKINA FASO</option>
<option value="BURUNDI">BURUNDI</option>
<option value="BUTAN">BUTAN</option>
<option value="CABO VERDE">CABO VERDE</option>
<option value="CAMBOYA">CAMBOYA</option>
<option value="CAMERUN">CAMERUN</option>
<option value="CANADA">CANADA</option>
<option value="CATAR">CATAR</option>
<option value="CHAD">CHAD</option>
<option value="CHILE">CHILE</option>
<option value="CHINA">CHINA</option>
<option value="CHIPRE">CHIPRE</option>
<option value="CIUDAD DEL VATICANO">CIUDAD DEL VATICANO</option>
<option value="COLOMBIA">COLOMBIA</option>
<option value="COMORAS">COMORAS</option>
<option value="COREA DEL NORTE">COREA DEL NORTE</option>
<option value="COREA DEL SUR">COREA DEL SUR</option>
<option value="COSTA DE MARFIL">COSTA DE MARFIL</option>
<option value="COSTA RICA">COSTA RICA</option>
<option value="CROACIA">CROACIA</option>
<option value="CUBA">CUBA</option>
<option value="DINAMARCA">DINAMARCA</option>
<option value="DOMINICA">DOMINICA</option>
<option value="ECUADOR">ECUADOR</option>
<option value="EGIPTO">EGIPTO</option>
<option value="EL SALVADOR">EL SALVADOR</option>
<option value="EMIRATOS ARABES UNIDOS">EMIRATOS ARABES UNIDOS</option>
<option value="ERITREA">ERITREA</option>
<option value="ESLOVAQUIA">ESLOVAQUIA</option>
<option value="ESLOVENIA">ESLOVENIA</option>
<option value="ESPAÑA">ESPAÑA</option>
<option value="ESTADOS UNIDOS">ESTADOS UNIDOS</option>
<option value="ESTONIA">ESTONIA</option>
<option value="ETIOPIA">ETIOPIA</option>
<option value="FILIPINAS">FILIPINAS</option>
<option value="FINLANDIA">FINLANDIA</option>
<option value="FIYI">FIYI</option>
<option value="FRANCIA">FRANCIA</option>
<option value="GABON">GABON</option>
<option value="GAMBIA">GAMBIA</option>
<option value="GEORGIA">GEORGIA</option>
<option value="GHANA">GHANA</option>
<option value="GIBRALTAR">GIBRALTAR</option>
<option value="GRANADA">GRANADA</option>
<option value="GRECIA">GRECIA</option>
<option value="GROENLANDIA">GROENLANDIA</option>
<option value="GUADALUPE">GUADALUPE</option>
<option value="GUAM">GUAM</option>
<option value="GUAYANA FRANCESA">GUAYANA FRANCESA</option>
<option value="GUINEA">GUINEA</option>
<option value="GUINEA ECUATORIAL">GUINEA ECUATORIAL</option>
<option value="GUINEA-BISSAU">GUINEA-BISSAU</option>
<option value="GUYANA">GUYANA</option>
<option value="HAITI">HAITI</option>
<option value="HONDURAS">HONDURAS</option>
<option value="HONG KONG">HONG KONG</option>
<option value="HUNGRIA">HUNGRIA</option>
<option value="INDIA">INDIA</option>
<option value="INDONESIA">INDONESIA</option>
<option value="IRAK">IRAK</option>
<option value="IRAN">IRAN</option>
<option value="IRLANDA">IRLANDA</option>
<option value="ISLA BOUVET">ISLA BOUVET</option>
<option value="ISLA DE NAVIDAD">ISLA DE NAVIDAD</option>
<option value="ISLANDIA">ISLANDIA</option>
<option value="ISLAS CAIMAN">ISLAS CAIMAN</option>
<option value="ISLAS COCOS">ISLAS COCOS</option>
<option value="ISLAS COOK">ISLAS COOK</option>
<option value="ISLAS FEROE">ISLAS FEROE</option>
<option value="ISLAS GEORGIAS DEL SUR Y SANDWICH DEL SUR">ISLAS GEORGIAS DEL SUR Y SANDWICH DEL SUR</option>
<option value="ISLAS HEARD Y MCDONALD">ISLAS HEARD Y MCDONALD</option>
<option value="ISLAS MALVINAS">ISLAS MALVINAS</option>
<option value="ISLAS MARIANAS DEL NORTE">ISLAS MARIANAS DEL NORTE</option>
<option value="ISLAS MARSHALL">ISLAS MARSHALL</option>
<option value="ISLAS PITCAIRN">ISLAS PITCAIRN</option>
<option value="ISLAS SALOMON">ISLAS SALOMON</option>
<option value="ISLAS TURCAS Y CAICOS">ISLAS TURCAS Y CAICOS</option>
<option value="ISLAS ULTRAMARINAS DE ESTADOS UNIDOS">ISLAS ULTRAMARINAS DE ESTADOS UNIDOS</option>
<option value="ISLAS VIRGENES BRITANICAS">ISLAS VIRGENES BRITANICAS</option>
<option value="ISLAS VIRGENES DE LOS ESTADOS UNIDOS">ISLAS VIRGENES DE LOS ESTADOS UNIDOS</option>
<option value="ISRAEL">ISRAEL</option>
<option value="ITALIA">ITALIA</option>
<option value="JAMAICA">JAMAICA</option>
<option value="JAPON">JAPON</option>
<option value="JORDANIA">JORDANIA</option>
<option value="KAZAJISTAN">KAZAJISTAN</option>
<option value="KENIA">KENIA</option>
<option value="KIRGUISTAN">KIRGUISTAN</option>
<option value="KIRIBATI">KIRIBATI</option>
<option value="KUWAIT">KUWAIT</option>
<option value="LAOS">LAOS</option>
<option value="LESOTO">LESOTO</option>
<option value="LETONIA">LETONIA</option>
<option value="LIBANO">LIBANO</option>
<option value="LIBERIA">LIBERIA</option>
<option value="LIBIA">LIBIA</option>
<option value="LIECHTENSTEIN">LIECHTENSTEIN</option>
<option value="LITUANIA">LITUANIA</option>
<option value="LUXEMBURGO">LUXEMBURGO</option>
<option value="MACAO">MACAO</option>
<option value="MADAGASCAR">MADAGASCAR</option>
<option value="MALASIA">MALASIA</option>
<option value="MALAUI">MALAUI</option>
<option value="MALDIVAS">MALDIVAS</option>
<option value="MALI">MALI</option>
<option value="MALTA">MALTA</option>
<option value="MARRUECOS">MARRUECOS</option>
<option value="MARTINICA">MARTINICA</option>
<option value="MAURICIO">MAURICIO</option>
<option value="MAURITANIA">MAURITANIA</option>
<option value="MAYOTTE">MAYOTTE</option>
<option value="MEXICO">MEXICO</option>
<option value="MICRONESIA">MICRONESIA</option>
<option value="MOLDAVIA">MOLDAVIA</option>
<option value="MONACO">MONACO</option>
<option value="MONGOLIA">MONGOLIA</option>
<option value="MONTSERRAT">MONTSERRAT</option>
<option value="MOZAMBIQUE">MOZAMBIQUE</option>
<option value="NAMIBIA">NAMIBIA</option>
<option value="NAURU">NAURU</option>
<option value="NEPAL">NEPAL</option>
<option value="NICARAGUA">NICARAGUA</option>
<option value="NIGER">NIGER</option>
<option value="NIGERIA">NIGERIA</option>
<option value="NIUE">NIUE</option>
<option value="NORFOLK">NORFOLK</option>
<option value="NORUEGA">NORUEGA</option>
<option value="NUEVA CALEDONIA">NUEVA CALEDONIA</option>
<option value="NUEVA ZELANDA">NUEVA ZELANDA</option>
<option value="OMAN">OMAN</option>
<option value="PAISES BAJOS">PAISES BAJOS</option>
<option value="PAKISTAN">PAKISTAN</option>
<option value="PALAOS">PALAOS</option>
<option value="PANAMA">PANAMA</option>
<option value="PAPUA NUEVA GUINEA">PAPUA NUEVA GUINEA</option>
<option value="PARAGUAY">PARAGUAY</option>
<option value="PERU">PERU</option>
<option value="POLINESIA FRANCESA">POLINESIA FRANCESA</option>
<option value="POLONIA">POLONIA</option>
<option value="PORTUGAL">PORTUGAL</option>
<option value="PUERTO RICO">PUERTO RICO</option>
<option value="REINO UNIDO">REINO UNIDO</option>
<option value="REP. DEM. DEL CONGO">REP. DEM. DEL CONGO</option>
<option value="REPUBLICA ARABE SAHARAUI DEMOCRATICA">REPUBLICA ARABE SAHARAUI DEMOCRATICA</option>
<option value="REPUBLICA CENTROAFRICANA">REPUBLICA CENTROAFRICANA</option>
<option value="REPUBLICA CHECA">REPUBLICA CHECA</option>
<option value="REPUBLICA DE MACEDONIA">REPUBLICA DE MACEDONIA</option>
<option value="REPUBLICA DEL CONGO">REPUBLICA DEL CONGO</option>
<option value="REPUBLICA DOMINICANA">REPUBLICA DOMINICANA</option>
<option value="REUNION">REUNION</option>
<option value="RUANDA">RUANDA</option>
<option value="RUMANIA">RUMANIA</option>
<option value="RUSIA">RUSIA</option>
<option value="SAMOA">SAMOA</option>
<option value="SAMOA AMERICANA">SAMOA AMERICANA</option>
<option value="SAN CRISTOBAL Y NIEVES">SAN CRISTOBAL Y NIEVES</option>
<option value="SAN MARINO">SAN MARINO</option>
<option value="SAN PEDRO Y MIQUELON">SAN PEDRO Y MIQUELON</option>
<option value="SAN VICENTE Y LAS GRANADINAS">SAN VICENTE Y LAS GRANADINAS</option>
<option value="SANTA HELENA, A. Y T.">SANTA HELENA, A. Y T.</option>
<option value="SANTA LUCIA">SANTA LUCIA</option>
<option value="SANTO TOME Y PRINCIPE">SANTO TOME Y PRINCIPE</option>
<option value="SENEGAL">SENEGAL</option>
<option value="SERBIA Y MONTENEGRO">SERBIA Y MONTENEGRO</option>
<option value="SEYCHELLES">SEYCHELLES</option>
<option value="SIERRA LEONA">SIERRA LEONA</option>
<option value="SINGAPUR">SINGAPUR</option>
<option value="SIRIA">SIRIA</option>
<option value="SOMALIA">SOMALIA</option>
<option value="SRI LANKA">SRI LANKA</option>
<option value="SUAZILANDIA">SUAZILANDIA</option>
<option value="SUDAFRICA">SUDAFRICA</option>
<option value="SUDAN">SUDAN</option>
<option value="SUECIA">SUECIA</option>
<option value="SUIZA">SUIZA</option>
<option value="SURINAM">SURINAM</option>
<option value="SVALBARD Y JAN MAYEN">SVALBARD Y JAN MAYEN</option>
<option value="TAILANDIA">TAILANDIA</option>
<option value="TAIWAN">TAIWAN</option>
<option value="TANZANIA">TANZANIA</option>
<option value="TAYIKISTAN">TAYIKISTAN</option>
<option value="TERRITORIO BRITANICO DEL OCEANO INDICO">TERRITORIO BRITANICO DEL OCEANO INDICO</option>
<option value="TERRITORIOS AUSTRALES FRANCESES">TERRITORIOS AUSTRALES FRANCESES</option>
<option value="TIMOR ORIENTAL">TIMOR ORIENTAL</option>
<option value="TOGO">TOGO</option>
<option value="TOKELAU">TOKELAU</option>
<option value="TONGA">TONGA</option>
<option value="TRINIDAD Y TOBAGO">TRINIDAD Y TOBAGO</option>
<option value="TUNEZ">TUNEZ</option>
<option value="TURKMENISTAN">TURKMENISTAN</option>
<option value="TURQUIA">TURQUIA</option>
<option value="TUVALU">TUVALU</option>
<option value="UCRANIA">UCRANIA</option>
<option value="UGANDA">UGANDA</option>
<option value="URUGUAY">URUGUAY</option>
<option value="UZBEKISTAN">UZBEKISTAN</option>
<option value="VANUATU">VANUATU</option>
<option value="VENEZUELA">VENEZUELA</option>
<option value="VIETNAM">VIETNAM</option>
<option value="WALLIS Y FUTUNA">WALLIS Y FUTUNA</option>
<option value="YEMEN">YEMEN</option>
<option value="YIBUTI">YIBUTI</option>
<option value="ZAMBIA">ZAMBIA</option>
<option value="ZIMBABUE">ZIMBABUE</option>
</select>
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<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Dirección particular según su recibo de servicios </span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 gnOLlR"><input autocomplete="on" class="StyledInput-sc-1cxwxcf-0 jskFPF fsFieldShortAnswer" id="field158562596" type="text" label="Dirección particular según su recibo de servicios " required=""
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<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>DPI parte de enfrente</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<div class="StyledLayout-sc-1njgxc8-0 fvbkrv"><input type="file" class="fsFieldFile" name="field158562597" id="field158562597" required=""
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style="display: none;"><input type="button" id="field158562597-choose-file" class="StyledInputButton-sc-1fdvaf7-0 gIaEMT fsFileUploadButton" aria-label="DPI parte de enfrente Elija el archivo" value="Elija el archivo"><input type="button"
data-testid="remove-button" id="field158562597-remove-file" class="StyledInputButton-sc-1fdvaf7-0 fGkemv fsFileUploadButton" aria-label="DPI parte de enfrente Remover archivo" value="Remover archivo"><span
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<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>DPI parte de atras</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<div class="StyledLayout-sc-1njgxc8-0 fvbkrv"><input type="file" class="fsFieldFile" name="field158562598" id="field158562598" required=""
accept="jpg,jpeg,gif,png,bmp,tif,psd,pdf,doc,docx,csv,xls,xlsx,txt,mp3,mp4,aac,wav,au,wmv,avi,mpg,mpeg,zip,gz,rar,z,tgz,tar,sitx" aria-hidden="true" data-fs-field-id="158562598" data-fs-field-name="file" data-fs-field-alias="*"
style="display: none;"><input type="button" id="field158562598-choose-file" class="StyledInputButton-sc-1fdvaf7-0 gIaEMT fsFileUploadButton" aria-label="DPI parte de atras Elija el archivo" value="Elija el archivo"><input type="button"
data-testid="remove-button" id="field158562598-remove-file" class="StyledInputButton-sc-1fdvaf7-0 fGkemv fsFileUploadButton" aria-label="DPI parte de atras Remover archivo" value="Remover archivo"><span
class="StyledFileUploadName-sc-7rq3k5-0 fPUBaL">Ningún archivo elegido</span></div>
</label><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562599" for="field158562599" data-testid="field-158562599"><a id="field-anchor-158562599" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Recibo de servicios </span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<div class="StyledLayout-sc-1njgxc8-0 fvbkrv"><input type="file" class="fsFieldFile" name="field158562599" id="field158562599" required=""
accept="jpg,jpeg,gif,png,bmp,tif,psd,pdf,doc,docx,csv,xls,xlsx,txt,mp3,mp4,aac,wav,au,wmv,avi,mpg,mpeg,zip,gz,rar,z,tgz,tar,sitx" aria-hidden="true" data-fs-field-id="158562599" data-fs-field-name="file" data-fs-field-alias="*"
style="display: none;"><input type="button" id="field158562599-choose-file" class="StyledInputButton-sc-1fdvaf7-0 gIaEMT fsFileUploadButton" aria-label="Recibo de servicios Elija el archivo" value="Elija el archivo"><input type="button"
data-testid="remove-button" id="field158562599-remove-file" class="StyledInputButton-sc-1fdvaf7-0 fGkemv fsFileUploadButton" aria-label="Recibo de servicios Remover archivo" value="Remover archivo"><span
class="StyledFileUploadName-sc-7rq3k5-0 fPUBaL">Ningún archivo elegido</span></div>
</label>
</div>
</div>
<div id="fsPage5610276-2" class="StyledPage-sc-15mrpfq-0 mBcRx fsPage fsHidden">
<div data-testid="section158562600-col1" id="fsSection158562600" class="StyledSection-sc-1jyjf4h-0 isdHqD fsSection">
<div class="StyledSectionHeader-sc-14xa0k7-0 jgMUUb fsSectionHeader">
<h2 class="StyledSectionHeading-sc-hpb4sc-0 jfhWLC fsSectionHeading">INFORMACION ECONOMICA</h2>
</div><span class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562601" for="field158562601" data-testid="field-158562601-horizontal"><a id="field-anchor-158562601" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Tipo de ingresos</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<fieldset aria-labelledby="158562601-legend" role="radiogroup" aria-required="true" class="StyledFieldset-sc-1r8yz9c-0 StyledOptionWrapper-sc-1ah0fdf-0 cdlqHK glshJU"><span
style="position: absolute; left: -999em; width: 0.1em; height: 0.1em; overflow: hidden;">
<legend id="158562601-legend">Tipo de ingresos</legend>
</span>
<div><label for="field158562601_1" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Tipo de ingresos" required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562601"
id="field158562601_1" data-fs-field-id="158562601" data-fs-field-name="radio" data-fs-field-alias="*" value="Suelo y Salarios">Suelo y Salarios</label></div>
<div><label for="field158562601_2" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Tipo de ingresos" required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562601"
id="field158562601_2" data-fs-field-id="158562601" data-fs-field-name="radio" data-fs-field-alias="*" value="Servicios profesionales">Servicios profesionales</label></div>
<div><label for="field158562601_3" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Tipo de ingresos" required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562601"
id="field158562601_3" data-fs-field-id="158562601" data-fs-field-name="radio" data-fs-field-alias="*" value="Manutención">Manutención</label></div>
<div><label for="field158562601_4" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Tipo de ingresos" required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562601"
id="field158562601_4" data-fs-field-id="158562601" data-fs-field-name="radio" data-fs-field-alias="*" value="Alquileres">Alquileres</label></div>
<div><label for="field158562601_5" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Tipo de ingresos" required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562601"
id="field158562601_5" data-fs-field-id="158562601" data-fs-field-name="radio" data-fs-field-alias="*" value="Jubilación">Jubilación</label></div>
<div><label for="field158562601_6" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Tipo de ingresos" required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562601"
id="field158562601_6" data-fs-field-id="158562601" data-fs-field-name="radio" data-fs-field-alias="*" value="Negocio Propio">Negocio Propio</label></div>
</fieldset>
</span><span class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562602" for="field158562602" data-testid="field-158562602-horizontal"><a id="field-anchor-158562602" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Ingresos mensuales aproximados </span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<fieldset aria-labelledby="158562602-legend" role="radiogroup" aria-required="true" class="StyledFieldset-sc-1r8yz9c-0 StyledOptionWrapper-sc-1ah0fdf-0 cdlqHK glshJU"><span
style="position: absolute; left: -999em; width: 0.1em; height: 0.1em; overflow: hidden;">
<legend id="158562602-legend">Ingresos mensuales aproximados </legend>
</span>
<div><label for="field158562602_1" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Ingresos mensuales aproximados " required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562602"
id="field158562602_1" data-fs-field-id="158562602" data-fs-field-name="radio" data-fs-field-alias="*" value="0.01 - 3,000">0.01 - 3,000</label></div>
<div><label for="field158562602_2" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Ingresos mensuales aproximados " required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562602"
id="field158562602_2" data-fs-field-id="158562602" data-fs-field-name="radio" data-fs-field-alias="*" value="3,001 - 10,000">3,001 - 10,000</label></div>
<div><label for="field158562602_3" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Ingresos mensuales aproximados " required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562602"
id="field158562602_3" data-fs-field-id="158562602" data-fs-field-name="radio" data-fs-field-alias="*" value="10,001 - 50,000">10,001 - 50,000</label></div>
<div><label for="field158562602_4" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Ingresos mensuales aproximados " required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562602"
id="field158562602_4" data-fs-field-id="158562602" data-fs-field-name="radio" data-fs-field-alias="*" value="50,001 - 100,000">50,001 - 100,000</label></div>
<div><label for="field158562602_5" class="StyledOptionLabel-sc-1bymt4x-0 gCpsuB fsOptionLabel"><input label="Ingresos mensuales aproximados " required="" class="StyledOptionButton-sc-wqe0tc-0 huXAjt" type="radio" name="field158562602"
id="field158562602_5" data-fs-field-id="158562602" data-fs-field-name="radio" data-fs-field-alias="*" value="100,001 - 200,000">100,001 - 200,000</label></div>
</fieldset>
</span><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562603" for="field158562603" data-testid="field-158562603"><a id="field-anchor-158562603" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Salario</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 gnOLlR"><input autocomplete="on" class="StyledInput-sc-1cxwxcf-0 jskFPF fsFieldShortAnswer" id="field158562603" type="text" label="Salario" required="" name="field158562603" placeholder=""
data-fs-field-id="158562603" data-fs-field-name="text" data-fs-field-alias="value" value=""></div>
</div>
</label><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562604" for="field158562604" data-testid="field-158562604"><a id="field-anchor-158562604" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Nombre de la empresa</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 gnOLlR"><input autocomplete="on" class="StyledInput-sc-1cxwxcf-0 jskFPF fsFieldShortAnswer" id="field158562604" type="text" label="Nombre de la empresa" required="" name="field158562604"
placeholder="" data-fs-field-id="158562604" data-fs-field-name="text" data-fs-field-alias="value" value=""></div>
</div>
</label><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562605" for="field158562605" data-testid="field-158562605"><a id="field-anchor-158562605" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Puesto a desempeñar</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 gnOLlR"><input autocomplete="on" class="StyledInput-sc-1cxwxcf-0 jskFPF fsFieldShortAnswer" id="field158562605" type="text" label="Puesto a desempeñar" required="" name="field158562605" placeholder=""
data-fs-field-id="158562605" data-fs-field-name="text" data-fs-field-alias="value" value=""></div>
</div>
</label>
</div>
<div data-testid="section158562606-col1" id="fsSection158562606" class="StyledSection-sc-1jyjf4h-0 isdHqD fsSection">
<div class="StyledSectionHeader-sc-14xa0k7-0 jgMUUb fsSectionHeader">
<h2 class="StyledSectionHeading-sc-hpb4sc-0 jfhWLC fsSectionHeading">DECLARACION PEP - CEP</h2>
</div><span class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562607" for="field158562607" data-testid="field-158562607-vertical"><a id="field-anchor-158562607" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel"><span>Es usted una persona políticamente expuesta (PEP)</span></div>
<fieldset aria-labelledby="158562607-legend" role="group" class="StyledFieldset-sc-1r8yz9c-0 StyledOptionWrapper-sc-1ah0fdf-0 cdlqHK PSYyM"><span style="position: absolute; left: -999em; width: 0.1em; height: 0.1em; overflow: hidden;">
<legend id="158562607-legend">Es usted una persona políticamente expuesta (PEP)</legend>
</span>
<div><label for="field158562607_1" class="StyledOptionLabel-sc-1bymt4x-0 lczbMC fsOptionLabel"><input label="Es usted una persona políticamente expuesta (PEP)" name="field158562607[]" class="StyledOptionButton-sc-wqe0tc-0 NQdHS"
type="checkbox" id="field158562607_1" data-fs-field-id="158562607" data-fs-field-name="checkbox" data-fs-field-alias="0" value="Si">Si</label></div>
<div><label for="field158562607_2" class="StyledOptionLabel-sc-1bymt4x-0 lczbMC fsOptionLabel"><input label="Es usted una persona políticamente expuesta (PEP)" name="field158562607[]" class="StyledOptionButton-sc-wqe0tc-0 NQdHS"
type="checkbox" id="field158562607_2" data-fs-field-id="158562607" data-fs-field-name="checkbox" data-fs-field-alias="1" value="No">No</label></div>
</fieldset>
</span><span class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562608" for="field158562608" data-testid="field-158562608-vertical"><a id="field-anchor-158562608" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel"><span>Tiene algun parentezco o es un asociado cercano a una persona expuesta políticamente</span></div>
<fieldset aria-labelledby="158562608-legend" role="group" class="StyledFieldset-sc-1r8yz9c-0 StyledOptionWrapper-sc-1ah0fdf-0 cdlqHK PSYyM"><span style="position: absolute; left: -999em; width: 0.1em; height: 0.1em; overflow: hidden;">
<legend id="158562608-legend">Tiene algun parentezco o es un asociado cercano a una persona expuesta políticamente</legend>
</span>
<div><label for="field158562608_1" class="StyledOptionLabel-sc-1bymt4x-0 lczbMC fsOptionLabel"><input label="Tiene algun parentezco o es un asociado cercano a una persona expuesta políticamente" name="field158562608[]"
class="StyledOptionButton-sc-wqe0tc-0 NQdHS" type="checkbox" id="field158562608_1" data-fs-field-id="158562608" data-fs-field-name="checkbox" data-fs-field-alias="0" value="Si">Si</label></div>
<div><label for="field158562608_2" class="StyledOptionLabel-sc-1bymt4x-0 lczbMC fsOptionLabel"><input label="Tiene algun parentezco o es un asociado cercano a una persona expuesta políticamente" name="field158562608[]"
class="StyledOptionButton-sc-wqe0tc-0 NQdHS" type="checkbox" id="field158562608_2" data-fs-field-id="158562608" data-fs-field-name="checkbox" data-fs-field-alias="1" value="No">No</label></div>
</fieldset>
</span><span class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562609" for="field158562609" data-testid="field-158562609-vertical"><a id="field-anchor-158562609" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel"><span>Es usted contratista o Proveedor del estado (CPE)</span></div>
<fieldset aria-labelledby="158562609-legend" role="group" class="StyledFieldset-sc-1r8yz9c-0 StyledOptionWrapper-sc-1ah0fdf-0 cdlqHK PSYyM"><span style="position: absolute; left: -999em; width: 0.1em; height: 0.1em; overflow: hidden;">
<legend id="158562609-legend">Es usted contratista o Proveedor del estado (CPE)</legend>
</span>
<div><label for="field158562609_1" class="StyledOptionLabel-sc-1bymt4x-0 lczbMC fsOptionLabel"><input label="Es usted contratista o Proveedor del estado (CPE)" name="field158562609[]" class="StyledOptionButton-sc-wqe0tc-0 NQdHS"
type="checkbox" id="field158562609_1" data-fs-field-id="158562609" data-fs-field-name="checkbox" data-fs-field-alias="0" value="Si">Si</label></div>
<div><label for="field158562609_2" class="StyledOptionLabel-sc-1bymt4x-0 lczbMC fsOptionLabel"><input label="Es usted contratista o Proveedor del estado (CPE)" name="field158562609[]" class="StyledOptionButton-sc-wqe0tc-0 NQdHS"
type="checkbox" id="field158562609_2" data-fs-field-id="158562609" data-fs-field-name="checkbox" data-fs-field-alias="1" value="No">No</label></div>
</fieldset>
</span>
</div>
</div>
<div id="fsPage5610276-3" class="StyledPage-sc-15mrpfq-0 mBcRx fsPage fsHidden">
<div data-testid="section158562610-col1" id="fsSection158562610" class="StyledSection-sc-1jyjf4h-0 isdHqD fsSection">
<div class="StyledSectionHeader-sc-14xa0k7-0 jgMUUb fsSectionHeader">
<h2 class="StyledSectionHeading-sc-hpb4sc-0 jfhWLC fsSectionHeading">DATOS DEL BENEFICIARIO</h2>
</div><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562611" for="field158562611" data-testid="field-158562611"><a id="field-anchor-158562611" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Nombre completo de su beneficiario</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div>
<div class="StyledSubFieldGroup-sc-ik27pq-0 gfzGQs fsSubFieldGroup">
<div class="StyledSubField-sc-1wt4t9i-0 gnOLlR"><input autocomplete="on" class="StyledInput-sc-1cxwxcf-0 jskFPF fsFieldShortAnswer" id="field158562611" type="text" label="Nombre completo de su beneficiario" required="" name="field158562611"
placeholder="" data-fs-field-id="158562611" data-fs-field-name="text" data-fs-field-alias="value" value=""></div>
</div>
</label><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562612" for="field158562612" data-testid="field-158562612"><a id="field-anchor-158562612" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel fsRequiredLabel"><span>Parentesco</span><span class="StyledRequiredMarker-sc-d195mo-0 fmxbpa fsRequiredMarker">*</span></div><select size="1" id="field158562612" type="select"
label="Parentesco" required="" class="StyledSelectInput-sc-1qjysc9-0 hUThWJ fsFieldSelect" name="field158562612" data-fs-field-id="158562612" data-fs-field-name="select" data-fs-field-alias="*">
<option value=""></option>
<option value="Madre">Madre</option>
<option value="Padre">Padre</option>
<option value="Hijo (a)">Hijo (a)</option>
<option value="Hermano (a)">Hermano (a)</option>
<option value="Conyugue">Conyugue</option>
<option value="Concuño (a)">Concuño (a)</option>
<option value="Primo (a)">Primo (a)</option>
</select>
</label><label class="StyledLabel-sc-vn5hkq-0 fnVZAc fsLabelVertical fsFieldCell" id="label-field158562613" for="field158562613" data-testid="field-158562613"><a id="field-anchor-158562613" tabindex="-1" aria-hidden="true"></a>
<div class="StyledLabelText-sc-1bsmirz-0 iuAosb fsLabel"><span>Estado civil de beneficiario</span></div><select size="1" id="field158562613" type="select" label="Estado civil de beneficiario"
class="StyledSelectInput-sc-1qjysc9-0 hUThWJ fsFieldSelect" name="field158562613" data-fs-field-id="158562613" data-fs-field-name="select" data-fs-field-alias="*">
<option value=""></option>
<option value="Soltero(a)">Soltero(a)</option>
<option value="Casado (a)">Casado (a)</option>
</select>
</label>
</div>
</div>
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aria-hidden="true"><span>Anterior</span></button>
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</div>
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</form>Text Content
Bienvenido al proceso de apertura para tu cuanta bancaria a continuación llena los datos que se te solicitan en el formulario APERTURA CUENTA MONETARIA Y/O AHORRO Estimado cliente te damos la bienvenida al proceso de apertura de tu cuenta monetaria y/o ahorro para pago de salario. Favor llenar los datos que se presentan a continuación Email Fecha de solicitud* Selecciona el tipo de cuenta que necesitas* MONETARIAAHORRO Selecciona el producto que necesitas para tu cuenta bancaria SOLO TARJETATARJETA Y CHEQUERASOLO CHEQUERA Selecciona el producto que necesitas para tu cuenta bancaria SOLO LIBRETALIBRETA Y TARJETA Ingrese su nombre completo ( como aparece en su DPI )* Genero* Genero Masculino Femenino Estado Civil* Soltero(a)Casado(a) Fecha de nacimiento* Numero de DPI o Pasaporte* Fecha de vencimiento de su DPI o pasaporte Numero de NIT Si no tiene NIT colocar N/A Numero de teléfono * Correo Electronico Profesion* PERITO CONTADORBACHILLER EN COMPUTACIONAYUDANTEFOTOGRAFOCULTORA DE BELLEZAINGENERIA AGRONOMAEJECUTIVAPANADEROCAJEROLICENCIATURA EN AUDITORIAPERITO EN ELECTRONICAAUXILIAR DE AUDITORPOLICIA NACIONAL CIVILEXPORTADORCATEDRATICOINGENERIA QUIMICAINGENERIA EN SISTEMASPERITO EN ADMON. DE PERSONALADMINISTRADORSERVICIO DOMESTICOLICENCIATURA EN MERCADEOLICENCIATURA EN PSICOLOGIA CLINICASECRETARIA COMERCIALCONSERJELICENCIATURA EN ECONOMIAMAESTRACARPINTERONINGUNAESTUDIANTECOMISARIOMAESTRO DE EDUCACION FISICABACHILLER EN TURISMOBOMBEROVENDEDOR DE BILLETES DE LOTERIAOPERARIOPERIODISTADOMESTICAINSTALADORJUBILADODIRECTOR GENERALPILOTOTRANSPORTISTAPERITO ELECTRISISTALICENCIATURA EN DERECHOALBANILDEPENDIENTE DE MOSTRADORINGENIERIA CIVILCOCINEROBACHILLER EN CIENCIAS Y LETRASQUIMICO BIOLOGOMAESTRO DE EDUCACION PRIMARIATAXISTASECRETARIA Y OFICINISTALICENCIATURA EN ADMINISTRACION PUBLICAMINISTRO EVANGELICOAGENTE DE SEGURIDADSECRETARIA CONTADORASEXTO PRIMARIAENFERMERACONSULTORAUDITOR Y CONTADORCONTADOR PUBLICOTECNICO EN SISTEMASJEFE DE AGENCIAANALISTABACHILLER INDUSTRIALTECNICO EN ADMO. DE PERSONALMESEROBACHILLER EN ELECTRONICAMISIONEROINDUSTRIALAGROPECUARIOPERITO EN ADMINISTRACION PUBLICAPERITO EN MERCADOTECNIAJORNALEROPERITO EN TURISMOINGENIERIA EN TELECOMUNICACIONESAGRICULTORAVICULTOREDUCACION PRIMARIA COMPLETAGERENTEPROGRAMADORASESOR DE VENTASPILOTO AVIADORQUIMICO FARMACEUTICOMEDICOMECANICOVETERINARIOOPERARIO DE MAQUILAPROCURADORGUARDAESPALDASMANTENIMIENTOINGENIERIA ELECTRICAPERITO EN ADMINISTRACION DE EMPRESASINGENERIA MECANICADIGITADORBODEGUEROBACHILLER ELECTRICISTALICENCIATURA EN PSICOLOGIA ESCOLARDENTISTAPROFESIONALZAPATEROEDUCACION BASICA COMPLETASECRETARIA BILINGUEPASTOR EVANGELICOTECNICO EN ELECTRONICAENCARGADOOTRAMENSAJEROCONSTRUCTORRECEPTOR PAGADORZOOTECNISTAVISITADOR MEDICOMAESTRO DE EDUCACION PRE-PRIMARIACRIMINOLOGOVENDEDOR RUTEROCOMERCIANTEABOGADO Y NOTARIOAMA DE CASAMAESTROSASTRELICENCIATURA EN ADMINISTRACION DE EMPRESASARQUITECTOSECRETARIA EJECUTIVA BILINGUEINGENERIA INDUSTRIALBANQUEROMILITARALQUILER DE CASASVENDEDORSECRETARIASUPERVISOR Pais de nacimiento* GUATEMALAAFGANISTANALANDALBANIAALEMANIAANDORRAANGOLAANGUILAANTÁRTIDAANTIGUA Y BARBUDAANTILLAS NEERLANDESASARABIA SAUDITAARGELIAARGENTINAARMENIAARUBAAUSTRALIAAUSTRIAAUTORIDAD NACIONAL PALESTINAAZERBAIYANBAHAMASBANGLADESBARBADOSBAREINBELGICABELICEBENINBERMUDASBIELORRUSIABIRMANIABOLIVIABOSNIA Y HERZEGOVINABOTSUANABRASILBRUNEIBULGARIABURKINA FASOBURUNDIBUTANCABO VERDECAMBOYACAMERUNCANADACATARCHADCHILECHINACHIPRECIUDAD DEL VATICANOCOLOMBIACOMORASCOREA DEL NORTECOREA DEL SURCOSTA DE MARFILCOSTA RICACROACIACUBADINAMARCADOMINICAECUADOREGIPTOEL SALVADOREMIRATOS ARABES UNIDOSERITREAESLOVAQUIAESLOVENIAESPAÑAESTADOS UNIDOSESTONIAETIOPIAFILIPINASFINLANDIAFIYIFRANCIAGABONGAMBIAGEORGIAGHANAGIBRALTARGRANADAGRECIAGROENLANDIAGUADALUPEGUAMGUAYANA FRANCESAGUINEAGUINEA ECUATORIALGUINEA-BISSAUGUYANAHAITIHONDURASHONG KONGHUNGRIAINDIAINDONESIAIRAKIRANIRLANDAISLA BOUVETISLA DE NAVIDADISLANDIAISLAS CAIMANISLAS COCOSISLAS COOKISLAS FEROEISLAS GEORGIAS DEL SUR Y SANDWICH DEL SURISLAS HEARD Y MCDONALDISLAS MALVINASISLAS MARIANAS DEL NORTEISLAS MARSHALLISLAS PITCAIRNISLAS SALOMONISLAS TURCAS Y CAICOSISLAS ULTRAMARINAS DE ESTADOS UNIDOSISLAS VIRGENES BRITANICASISLAS VIRGENES DE LOS ESTADOS UNIDOSISRAELITALIAJAMAICAJAPONJORDANIAKAZAJISTANKENIAKIRGUISTANKIRIBATIKUWAITLAOSLESOTOLETONIALIBANOLIBERIALIBIALIECHTENSTEINLITUANIALUXEMBURGOMACAOMADAGASCARMALASIAMALAUIMALDIVASMALIMALTAMARRUECOSMARTINICAMAURICIOMAURITANIAMAYOTTEMEXICOMICRONESIAMOLDAVIAMONACOMONGOLIAMONTSERRATMOZAMBIQUENAMIBIANAURUNEPALNICARAGUANIGERNIGERIANIUENORFOLKNORUEGANUEVA CALEDONIANUEVA ZELANDAOMANPAISES BAJOSPAKISTANPALAOSPANAMAPAPUA NUEVA GUINEAPARAGUAYPERUPOLINESIA FRANCESAPOLONIAPORTUGALPUERTO RICOREINO UNIDOREP. DEM. DEL CONGOREPUBLICA ARABE SAHARAUI DEMOCRATICAREPUBLICA CENTROAFRICANAREPUBLICA CHECAREPUBLICA DE MACEDONIAREPUBLICA DEL CONGOREPUBLICA DOMINICANAREUNIONRUANDARUMANIARUSIASAMOASAMOA AMERICANASAN CRISTOBAL Y NIEVESSAN MARINOSAN PEDRO Y MIQUELONSAN VICENTE Y LAS GRANADINASSANTA HELENA, A. Y T.SANTA LUCIASANTO TOME Y PRINCIPESENEGALSERBIA Y MONTENEGROSEYCHELLESSIERRA LEONASINGAPURSIRIASOMALIASRI LANKASUAZILANDIASUDAFRICASUDANSUECIASUIZASURINAMSVALBARD Y JAN MAYENTAILANDIATAIWANTANZANIATAYIKISTANTERRITORIO BRITANICO DEL OCEANO INDICOTERRITORIOS AUSTRALES FRANCESESTIMOR ORIENTALTOGOTOKELAUTONGATRINIDAD Y TOBAGOTUNEZTURKMENISTANTURQUIATUVALUUCRANIAUGANDAURUGUAYUZBEKISTANVANUATUVENEZUELAVIETNAMWALLIS Y FUTUNAYEMENYIBUTIZAMBIAZIMBABUE Dirección particular según su recibo de servicios * DPI parte de enfrente* Ningún archivo elegido DPI parte de atras* Ningún archivo elegido Recibo de servicios * Ningún archivo elegido INFORMACION ECONOMICA Tipo de ingresos* Tipo de ingresos Suelo y Salarios Servicios profesionales Manutención Alquileres Jubilación Negocio Propio Ingresos mensuales aproximados * Ingresos mensuales aproximados 0.01 - 3,000 3,001 - 10,000 10,001 - 50,000 50,001 - 100,000 100,001 - 200,000 Salario* Nombre de la empresa* Puesto a desempeñar* DECLARACION PEP - CEP Es usted una persona políticamente expuesta (PEP) Es usted una persona políticamente expuesta (PEP) Si No Tiene algun parentezco o es un asociado cercano a una persona expuesta políticamente Tiene algun parentezco o es un asociado cercano a una persona expuesta políticamente Si No Es usted contratista o Proveedor del estado (CPE) Es usted contratista o Proveedor del estado (CPE) Si No DATOS DEL BENEFICIARIO Nombre completo de su beneficiario* Parentesco* MadrePadreHijo (a)Hermano (a)ConyugueConcuño (a)Primo (a) Estado civil de beneficiario Soltero(a)Casado (a) Anterior Página 1 de 3 Siguiente