Notarial Service User Form - Carchi
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ScribdTranslationsNotarial Service User Form - Carchi
Translated by
ScribdTranslationsFORM FOR USERS OF NOTARIAL SERVICE
Second Notary - Carchi - Montufar / San Gabriel
In compliance with Article 4 literal "a" of the Organic Law on the Prevention, Detection, and Eradication of Money Laundering
Assets and Financing of Crimes, Article 7, 46, 47, 48 of the General Regulations to the Organic Law on Prevention, Detection and
Eradication of the Crime of Money Laundering and the Financing of Crimes; as well as in compliance with the Manual for the
Prevention of Money Laundering and Financing of Crimes for Notarial Services, the following registration is proceeded.
information.
Form No. 01575
1.-Datos Transacción
BUYING AND SELLING
Script: 20230405002D00583 Date: 2023-11-14
Description: SALE OF TRUCK WITH LICENSE PLATE IBB6041
Good: VEHICLE Amount: 3000 Appraisal: 3000
Province: CARCHI Canton: MONTUFER
Address: Canchaguano Community, San José parish, Montúfar canton
2.-Parties Involved
Identification: 0401097910 Names / Company Name: ALICIA ELIZABETH GUACHAGMIRA BASTIDAS
Role: GRANTED BY Quality: SALESPERSON
Sexo: FEMENINO E-mail: merylore88@[Link] Fecha Nacimiento: 01/11/1978
Cell phone: 0993595822 Telefono: 0000000000 Nationality: Ecuador Monthly Income: 0.00 USD
Estado Civil: SINGLE Spouse: ........................
Occupation: LAWYER
Provincia: CARCHI Canton: MONTUFAR
Address: Canchaguano Community, San José parish, Montúfar canton
I, ALICIA ELIZABETH GUACHAGMIRA BASTIDAS with identification document No. 0401097910, inform that I have read the Minimum List of Public Positions to be considered.
"Politically Exposed Persons (PEPs)" and I declare under oath that I am "NOT" currently holding any of the positions mentioned in that document; additionally, I declare
I swear that I have no relationship of any kind with any of the individuals listed in the PEP List.
Identification: 0401843982 Names / Business Name: Carmen Irene Benavides Tepu
Role: In favor of Quality: BUYER
Sexo: FEMININE E-mail: Fecha Nacimiento: 11/05/1999
Cellular: 0988873320 Telefono: Nationality: Ecuador Monthly Income: 0.00 USD
Estado Civil: SINGLE Conjugate: ........................
Occupation: STUDENT
Province: CARCHI Canton: MONTUFAR
Address: Carchi Street, San Miguel neighborhood, Cristóbal Colón parish, Montúfar canton
I, CARMEN IRENE BENAVIDES TEPU with identification number No. 0401843982, inform that I have read the Minimum List of Public Positions to be considered 'Persons
Politically Exposed Persons (PEPs)" and I declare under oath that "I am NOT holding any of the positions mentioned in that document; additionally, I declare under
I swear that I have 'NO' relationship of any kind with any of the individuals on the PEP List.
3.-Payment Data
Forma de Pago Amount Currency Financial Institution Reference Date
CASH 3000.00 US DOLLAR DOES NOT HAVE 0 11/14/2023
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4.- Declaration of origin and destination of economic values
We declare that the economic values recorded in this transaction have no origin or destination in any type of illegal or illicit activity related to
the production, consumption, marketing of narcotic and psychotropic substances, nor the money laundering of fixed assets, nor the collection of financing funds
terrorism or any other activity classified in the Current Law. We exempt Ms. MARIA ROSARIO NAVARRETE in her capacity as NOTARY
SECOND CANTON MONTUFAR of all responsibility including regarding third parties, if this declaration is false or erroneous. We waive the execution
any action or intention in the civil, criminal, or any other field. We expressly authorize the Second Notary - Carchi - Montufar / San
Gabriel to carry out the analysis he deems appropriate and inform the competent authorities in case of investigation and/or determination of
unusual or suspicious transactions. We declare that the information provided is our sole responsibility as well as its truthfulness.
ALICIA ELIZABETH GUACHAGMIRA BASTIDAS Carmen Irene Benavides Tepu
0401097910 0401843982
Salesperson BUYER
COMPLIANCE OFFICER MATRIXER
Second Notary - Carchi - Montufar / San Gabriel Second Notary - Carchi - Montufar / San Gabriel
Sister Maria Rosario Navarrete
SECOND NOTARY OFFICE CANTON MONTUFAR
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