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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 Mail, Fax or E-mail, completed and signed with any purchases and / or reservations. Copyright ©, 2000-2020. All rights and images reserved. I Love Latins .

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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