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281-481-0036

New Law
Affects You!
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INTERNATIONAL MARRIAGE BROKER REGULATION ACT OF 2005
On January 05, 2006, President Bush signed into law the
"International Marriage Broker Regulation Act of 2005",
H.R. 3402, Public Law No. 109-162, Title VIII, Subtitle D.


If you answer "YES" to any of the questions below,
please provide us with more detailed information and any applicable documents.
Please use additional pages if necessary.

CLIENT BACKGROUND INFORMATION UNDER

INTERNATIONAL MARRIAGE BROKER REGULATION ACT OF 2005

 

FULL NAME: _______________________________________________________________

ADDRESS WITH ZIP CODE: __________________________________________________

TELEPHONE: _______________________________________________________________

E-MAIL ADDRESS: __________________________________________________________

DATE OF BIRTH: ____________________________________________________________

DO YOU HAVE: (i) Any temporary or permanent civil protection order
or restraining order issued against the United States client.

NO:________________

YES:_______________

EXPLAIN:_________________________________________________

(ii) Any Federal, State, or local arrest or conviction of the United States client for homicide,
murder, manslaughter, assault, battery, domestic violence, rape, sexual assault,
abusive sexual contact, sexual exploitation, incest, child abuse or neglect, torture,
trafficking, peonage, holding hostage, involuntary servitude, slave trade, kidnapping,
abduction, unlawful criminal restraint, false imprisonment, or stalking.

NO:________________

YES:_______________

EXPLAIN:_________________________________________________

PAGE TWO (2)

(iii) Any Federal, State, or local arrest or conviction of the United States client for--

(I) solely, principally, or incidentally engaging in prostitution;

(II) a direct or indirect attempt to procure prostitutes or persons for the purpose of prostitution; or

(III) receiving, in whole or in part, of the proceeds of prostitution.

NO:________________

YES:_______________

EXPLAIN:_________________________________________________

(iv) Any Federal, State, or local arrest or conviction of the United States client
for offenses related to controlled substances or alcohol.

NO:________________

YES:_______________

EXPLAIN:_________________________________________________

(v) Marital history of the United States client, including whether the client is currently married,
whether the client has previously been married and how many times, how previous marriages
of the client were terminated and the date of termination, and whether the client
has previously sponsored an alien to whom the client was engaged or married.

NO:________________

YES:_______________

EXPLAIN:_________________________________________________

(vi) The ages of any of the United States client's children who are under the age of 18.

NO:________________

YES:_______________

EXPLAIN:_________________________________________________

(vii) All States and countries in which the United States client
has resided since the client was 18 years of age.

NO:________________

YES:_______________

EXPLAIN:________________________________________________

I _________________________, CERTIFY AND ATTEST, under penalty of perjury
and false statement, that my above client background information is true and complete.
I also give my permission to I LOVE LATINS to release and provide this information
in any format to all interested foreign ladies available. I have provided any necessary
additional truthful documentation to all questions answered ‘Yes’ above.
I hereby WAIVE ANY PRIVACY RIGHTS FROM RELEASE OF THIS INFORMATION.
I ALSO HEREBY RELEASE AND HOLD HARMLESS AND FOREVER DISCHARGE
I LOVE LATINS FROM ANY AND ALL LIABILITIES
arising from my release of this information and any use of it.

___________________________________________ Signature

 _____/______/______ Date



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Copyright ©, 2000-2020. All rights and images reserved. I Love Latins .

Be Informed.  Know the Facts.

New Law Affects I Love Latins / Barranquilla Beauties and You,
North American Gentlemen seeking good, Sincere Foreign wives!

Contact us personally with any questions & / or comments:
"I Love Latins &
Barranquilla Beauties truly cares about you!"

Sam and Consuelo Smith 
11517 Sabo Road 
Houston, Texas 77089 USA

281-481-0036 Phone
832-385-4161 USA Cell phone
e-mail us 24/7

Sam@ilovelatins.com

www.iLoveLatins.com 
 

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