{"id":295,"date":"2019-12-03T12:35:51","date_gmt":"2019-12-03T20:35:51","guid":{"rendered":"https:\/\/collectmoore.com\/es\/?page_id=295"},"modified":"2021-01-13T09:07:29","modified_gmt":"2021-01-13T17:07:29","slug":"solicitud-de-informacion-recopilada","status":"publish","type":"page","link":"https:\/\/collectmoore.com\/es\/solicitud-de-informacion-recopilada\/","title":{"rendered":"Solicitud de informaci\u00f3n recopilada"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-jw2j09wo-10791e17e3e4040475f4747dd32ea0f8\">\n.avia-section.av-jw2j09wo-10791e17e3e4040475f4747dd32ea0f8{\nbackground-repeat:no-repeat;\nbackground-image:url(https:\/\/collectmoore.com\/es\/wp-content\/uploads\/sites\/3\/2019\/04\/bluetexturebkg.jpg);\nbackground-position:50% 50%;\nbackground-attachment:scroll;\n}\n<\/style>\n<div id='av_section_1'  class='avia-section av-jw2j09wo-10791e17e3e4040475f4747dd32ea0f8 main_color avia-section-default avia-no-border-styling  avia-builder-el-0  el_before_av_section  avia-builder-el-first  avia-full-stretch avia-bg-style-scroll av-minimum-height av-minimum-height-custom av-height-custom  container_wrap fullsize'  data-section-bg-repeat='stretch' data-av_minimum_height_px='300'><div class='container av-section-cont-open' style='height:300px'><main  role=\"main\" itemprop=\"mainContentOfPage\"  class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-295'><div class='entry-content-wrapper clearfix'>\n<div class='flex_column_table av-1x3do1-e267b30e4f320952c33781ced78ca19c sc-av_three_fourth av-equal-height-column-flextable'>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-1x3do1-e267b30e4f320952c33781ced78ca19c\">\n.flex_column.av-1x3do1-e267b30e4f320952c33781ced78ca19c{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-1x3do1-e267b30e4f320952c33781ced78ca19c av_three_fourth  avia-builder-el-1  el_before_av_one_fourth  avia-builder-el-first  first flex_column_table_cell av-equal-height-column av-align-middle av-zero-column-padding  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-k3qbn43u-354012a7df255ca2a3a732947893731f\">\n#top .av-special-heading.av-k3qbn43u-354012a7df255ca2a3a732947893731f{\npadding-bottom:10px;\ncolor:#ffffff;\nfont-size:64px;\n}\nbody .av-special-heading.av-k3qbn43u-354012a7df255ca2a3a732947893731f .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n#top #wrap_all .av-special-heading.av-k3qbn43u-354012a7df255ca2a3a732947893731f .av-special-heading-tag{\nfont-size:64px;\n}\n.av-special-heading.av-k3qbn43u-354012a7df255ca2a3a732947893731f .special-heading-inner-border{\nborder-color:#ffffff;\n}\n.av-special-heading.av-k3qbn43u-354012a7df255ca2a3a732947893731f .av-subheading{\nfont-size:15px;\n}\n\n@media only screen and (min-width: 768px) and (max-width: 989px){ \n#top #wrap_all .av-special-heading.av-k3qbn43u-354012a7df255ca2a3a732947893731f .av-special-heading-tag{\nfont-size:52px;\n}\n}\n\n@media only screen and (min-width: 480px) and (max-width: 767px){ \n#top #wrap_all .av-special-heading.av-k3qbn43u-354012a7df255ca2a3a732947893731f .av-special-heading-tag{\nfont-size:48px;\n}\n}\n\n@media only screen and (max-width: 479px){ \n#top #wrap_all .av-special-heading.av-k3qbn43u-354012a7df255ca2a3a732947893731f .av-special-heading-tag{\nfont-size:36px;\n}\n}\n<\/style>\n<div  class='av-special-heading av-k3qbn43u-354012a7df255ca2a3a732947893731f av-special-heading-h1 custom-color-heading blockquote modern-quote  avia-builder-el-2  avia-builder-el-no-sibling  av-inherit-size'><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >Solicitud de informaci\u00f3n recopilada<\/h1><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div><\/div><div class='av-flex-placeholder'><\/div>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-73ig1-a28f3a8eaffa7212ea1a334dd6332645\">\n.flex_column.av-73ig1-a28f3a8eaffa7212ea1a334dd6332645{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-73ig1-a28f3a8eaffa7212ea1a334dd6332645 av_one_fourth  avia-builder-el-3  el_after_av_three_fourth  avia-builder-el-last  flex_column_table_cell av-equal-height-column av-align-middle av-zero-column-padding  '     ><style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-jyhmg8qx-e4ad7622c552470ed475e601e9114209\">\n#top .av_textblock_section.av-jyhmg8qx-e4ad7622c552470ed475e601e9114209 .avia_textblock{\ncolor:#ffffff;\n}\n<\/style>\n<section  class='av_textblock_section av-jyhmg8qx-e4ad7622c552470ed475e601e9114209 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock av_inherit_color'  itemprop=\"text\" ><p><em>Aviso: The Moore Law Group es un cobrador de deudas. Esto es un intento de cobrar una deuda; cualquier informaci\u00f3n obtenida ser\u00e1 utilizada para ese prop\u00f3sito.<\/em><\/p>\n<\/div><\/section><\/div><\/div><!--close column table wrapper. Autoclose: 1 -->\n\n<\/div><\/div><\/main><!-- close content main element --><\/div><\/div><div id='av_section_2'  class='avia-section av-1pz0i1-8979abe76d754ddbca2c96a19c58533b main_color avia-section-default avia-no-border-styling  avia-builder-el-5  el_after_av_section  avia-builder-el-last  avia-bg-style-scroll container_wrap fullsize'  ><div class='container av-section-cont-open' ><div class='template-page content  av-content-full alpha units'><div class='post-entry post-entry-type-page post-entry-295'><div class='entry-content-wrapper clearfix'>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-1h51qp-e8448241223d8c2f44f2a6564eb74a0e\">\n.flex_column.av-1h51qp-e8448241223d8c2f44f2a6564eb74a0e{\nborder-radius:0px 0px 0px 0px;\npadding:0px 0px 0px 0px;\n}\n<\/style>\n<div  class='flex_column av-1h51qp-e8448241223d8c2f44f2a6564eb74a0e av_two_third  avia-builder-el-6  avia-builder-el-no-sibling  first flex_column_div av-zero-column-padding  '     ><section  class='av_textblock_section av-jw2j41or-ea1c59e4cdd6b3de0b1c47322bf9241c '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h2>Solicitud de informaci\u00f3n recopilada<\/h2>\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_4' style='display:none'>\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_4'  action='\/es\/wp-json\/wp\/v2\/pages\/295' data-formid='4' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_4' class='gform_fields top_label form_sublabel_below description_below validation_below' data-column-layout='fill'><li id=\"field_4_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"e6193890\" data-field-span=\"12\"><h2 class=\"gsection_title\"><\/h2><div class='gsection_description' id='gfield_description_4_16'>Solicitud de identificaci\u00f3n de la informaci\u00f3n recopilada | Solicitud de limitaci\u00f3n del uso de la informaci\u00f3n | Solicitada para la eliminaci\u00f3n de la informaci\u00f3n | Solicitud para corregir informaci\u00f3n personal inexacta (SOLAMENTE RESIDENTES DE CALIFORNIA) <\/div><\/li><li id=\"field_4_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"12ed01c6\" data-field-span=\"12\"><label id='gfield_label_4_1' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Nombre<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_4_1'>\n                            \n                            <span id='input_4_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_4_1_3' value=''   aria-required='true'   placeholder='Nombre' autocomplete=\"given-name\" aria-labelledby=\"input_4_1_3_label gfield_label_4_1\"\/>\n                                                    <label for='input_4_1_3' id='input_4_1_3_label' class='gform-field-label gform-field-label--type-sub '>Primero<\/label>\n                                                <\/span>\n                            \n                            <span id='input_4_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_4_1_6' value=''   aria-required='true'   placeholder='Apellido' autocomplete=\"family-name\" \/>\n                                                    <label for='input_4_1_6' id='input_4_1_6_label' class='gform-field-label gform-field-label--type-sub '>Apellido<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_4_2\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"c905e8a9\" data-field-span=\"12\"><label id='gfield_label_4_2' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Direcci\u00f3n F\u00edsica<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_4_2' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_4_2_1_container' >\n                                        <input type='text' name='input_2.1' id='input_4_2_1' value=''   placeholder='Direcci\u00f3n' aria-required='true'   autocomplete=\"address-line1\" aria-labelledby=\"input_4_2_1_label gfield_label_4_2\"\/>\n                                        <label for='input_4_2_1' id='input_4_2_1_label' class='gform-field-label gform-field-label--type-sub '>Direcci\u00f3n<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_4_2_2_container' >\n                                        <input type='text' name='input_2.2' id='input_4_2_2' value=''   placeholder='N\u00famero de unidad o suite' autocomplete=\"address-line2\" aria-required='false'   \/>\n                                        <label for='input_4_2_2' id='input_4_2_2_label' class='gform-field-label gform-field-label--type-sub '>N\u00famero de unidad o suite<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_4_2_3_container' >\n                                    <input type='text' name='input_2.3' id='input_4_2_3' value=''   placeholder='Ciudad' aria-required='true'   autocomplete=\"address-level2\" \/>\n                                    <label for='input_4_2_3' id='input_4_2_3_label' class='gform-field-label gform-field-label--type-sub '>Ciudad<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_4_2_4_container' >\n                                        <select name='input_2.4' id='input_4_2_4'     aria-required='true'   autocomplete=\"address-level1\" ><option value='' >Estado<\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' selected='selected'>California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_4_2_4' id='input_4_2_4_label' class='gform-field-label gform-field-label--type-sub '>Estado<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_4_2_5_container' >\n                                    <input type='text' name='input_2.5' id='input_4_2_5' value=''   placeholder='C\u00f3digo postal' aria-required='true'   autocomplete=\"postal-code\" \/>\n                                    <label for='input_4_2_5' id='input_4_2_5_label' class='gform-field-label gform-field-label--type-sub '>C\u00f3digo postal<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_2.6' id='input_4_2_6' value='US' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_4_3\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"326d78bd\" data-field-span=\"12\"><label id='gfield_label_4_3' class='gfield_label gform-field-label' for='input_4_3'><span class='gform-field-label__text'>Telefono<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_3' id='input_4_3' type='tel' value='' class='medium'  placeholder='Telefono' aria-required=\"true\" aria-invalid=\"false\"  autocomplete=\"tel\" data-mask=\"(999) 999-9999\" \/><\/div><\/li><li id=\"field_4_4\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_hidden_label gfield--has-description field_description_above field_validation_below gfield_visibility_visible\" data-group-id=\"bc0c0c86\" data-field-span=\"12\"><label id='gfield_label_4_4' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Correo Electr\u00f3nico<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_4_4'>Por favor asegurese que el correo electronico que proporcione sea privado.  Correos electronicos enviados a una cuenta de correo electronico de la empresa no se consideran privados, ya que los empleadores son libres de controlar esas comunicaciones.<\/div><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_4_4_container'>\n                                <span id='input_4_4_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_4' id='input_4_4' value=''   placeholder='Agrege correo electronico' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_4_4\" aria-labelledby=\"input_4_4_label gfield_label_4_4\" autocomplete=\"email\"\/>\n                                    <label for='input_4_4' id='input_4_4_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_4_4_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_4_2' id='input_4_4_2' value=''   placeholder='Confirme correo electronico' aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_4_4\" autocomplete=\"email\"\/>\n                                    <label for='input_4_4_2' id='input_4_4_2_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_4_8\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"75e0d5c3\" data-field-span=\"12\"><label id='gfield_label_4_8' class='gfield_label gform-field-label' for='input_4_8'><span class='gform-field-label__text'>\u00daltimos 4 d\u00edgitos del N\u00famero de Seguridad Social<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_4_8' type='text' value='' class='medium'    placeholder='\u00daltimos 4 d\u00edgitos del N\u00famero de Seguridad Social' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"9999\"\/><\/div><\/li><li id=\"field_4_5\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"54dea089\" data-field-span=\"12\"><label id='gfield_label_4_5' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Fecha de nacimiento<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_4_5' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_4_5_1_container'><label for='input_4_5_1' id='input_4_5_1_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Mes<\/label><select name='input_5[]' id='input_4_5_1'   aria-required='true'   aria-labelledby=\"input_4_5_1_label gfield_label_4_5\" ><option value=''>Mes<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_4_5_2_container'><label for='input_4_5_2' id='input_4_5_2_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Dia<\/label><select name='input_5[]' id='input_4_5_2'   aria-required='true'  ><option value=''>Dia<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_4_5_3_container'><label for='input_4_5_3' id='input_4_5_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>A\u00f1o<\/label><select name='input_5[]' id='input_4_5_3'   aria-required='true'  ><option value=''>A\u00f1o<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_4_15\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"7efabdfb\" data-field-span=\"12\"><label id='gfield_label_4_15' class='gfield_label gform-field-label' for='input_4_15'><span class='gform-field-label__text'>El n\u00famero de cuenta de Moore Law Group (si se conoce)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_15' id='input_4_15' type='text' value='' class='medium'    placeholder='El n\u00famero de cuenta de Moore Law Group (si se conoce)'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_4_19\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_4_19' class='gfield_label gform-field-label' for='input_4_19'><span class='gform-field-label__text'>El n\u00famero de cuenta de Moore Law Group (opcional)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_4_19' type='text' value='' class='large'    placeholder='El n\u00famero de cuenta de Moore Law Group (opcional)'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_4_20\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_4_20' class='gfield_label gform-field-label' for='input_4_20'><span class='gform-field-label__text'>Nombre del acreedor actual (opcional)<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_4_20' type='text' value='' class='large'    placeholder='Nombre del acreedor actual (opcional)'  aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_4_9\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"b102dbf2\" data-field-span=\"12\"><h2 class=\"gsection_title\">Solicitudes<\/h2><div class='gsection_description' id='gfield_description_4_9'>De conformidad con la Ley de Privacidad del Consumidor de California, por este conducto declaro bajo pena de perjurio que la informaci\u00f3n antes proporcionada es fiel y exacta y que el suscrito (el individuo antes descrito) soy la persona que est\u00e1 proporcionando la informaci\u00f3n anterior. <\/div><\/li><li id=\"field_4_7\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"6b75eab7\" data-field-span=\"12\"><label id='gfield_label_4_7' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Por la presente, solicito las categor\u00edas personales de informaci\u00f3n que se han recopilado sobre m\u00ed.<\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_7.1' id='input_4_7_1' type='checkbox' value='1'   aria-labelledby=\"input_4_7_1_label gfield_label_4_7\"  aria-invalid=\"false\"   \/> <label id='input_4_7_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_7_1' ><span class='gform-field-label__text'>Por la presente, solicito las categor\u00edas personales de informaci\u00f3n que se han recopilado sobre m\u00ed.<\/span><\/label><input type='hidden' name='input_7.2' value='Por la presente, solicito las categor\u00edas personales de informaci\u00f3n que se han recopilado sobre m\u00ed.' class='gform_hidden' \/><input type='hidden' name='input_7.3' value='1' class='gform_hidden' \/><\/div><\/li><li id=\"field_4_10\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"e403389c\" data-field-span=\"12\"><label id='gfield_label_4_10' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Por la presente, solicito la identificaci\u00f3n de la informaci\u00f3n personal espec\u00edfica que han recopilado sobre m\u00ed.<\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_10.1' id='input_4_10_1' type='checkbox' value='1'   aria-labelledby=\"input_4_10_1_label gfield_label_4_10\"  aria-invalid=\"false\"   \/> <label id='input_4_10_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_10_1' ><span class='gform-field-label__text'>Por la presente, solicito la identificaci\u00f3n de la informaci\u00f3n personal espec\u00edfica que han recopilado sobre m\u00ed.<\/span><\/label><input type='hidden' name='input_10.2' value='Por la presente, solicito la identificaci\u00f3n de la informaci\u00f3n personal espec\u00edfica que han recopilado sobre m\u00ed.' class='gform_hidden' \/><input type='hidden' name='input_10.3' value='1' class='gform_hidden' \/><\/div><\/li><li id=\"field_4_11\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"92d46319\" data-field-span=\"12\"><label id='gfield_label_4_11' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Por medio de la presente solicito las categor\u00edas de terceros de los que se recopila la informaci\u00f3n personal.<\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_11.1' id='input_4_11_1' type='checkbox' value='1'   aria-labelledby=\"input_4_11_1_label gfield_label_4_11\"  aria-invalid=\"false\"   \/> <label id='input_4_11_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_11_1' ><span class='gform-field-label__text'>Por medio de la presente solicito las categor\u00edas de terceros de los que se recopila la informaci\u00f3n personal.<\/span><\/label><input type='hidden' name='input_11.2' value='Por medio de la presente solicito las categor\u00edas de terceros de los que se recopila la informaci\u00f3n personal.' class='gform_hidden' \/><input type='hidden' name='input_11.3' value='1' class='gform_hidden' \/><\/div><\/li><li id=\"field_4_23\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"2e9e30c9\" data-field-span=\"12\"><label id='gfield_label_4_23' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Por la presente, solicito las categor\u00edas de informaci\u00f3n personal que ha divulgado sobre m\u00ed con fines comerciales y las categor\u00edas de personas a las que se divulg\u00f3 con fines comerciales.<\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_23.1' id='input_4_23_1' type='checkbox' value='1'   aria-labelledby=\"input_4_23_1_label gfield_label_4_23\"  aria-invalid=\"false\"   \/> <label id='input_4_23_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_23_1' ><span class='gform-field-label__text'>Por la presente, solicito las categor\u00edas de informaci\u00f3n personal que ha divulgado sobre m\u00ed con fines comerciales y las categor\u00edas de personas a las que se divulg\u00f3 con fines comerciales.<\/span><\/label><input type='hidden' name='input_23.2' value='Por la presente, solicito las categor\u00edas de informaci\u00f3n personal que ha divulgado sobre m\u00ed con fines comerciales y las categor\u00edas de personas a las que se divulg\u00f3 con fines comerciales.' class='gform_hidden' \/><input type='hidden' name='input_23.3' value='1' class='gform_hidden' \/><\/div><\/li><li id=\"field_4_24\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"f1ae19d2\" data-field-span=\"12\"><label id='gfield_label_4_24' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Por la presente, solicito la limitaci\u00f3n del uso y la divulgaci\u00f3n de la siguiente informaci\u00f3n personal que ha recopilado sobre m\u00ed. (Reconozco que la informaci\u00f3n personal que solicito que se limite puede estar sujeta a varias excepciones y que usted me informar\u00e1 si mi solicitud no puede ser atendida debido a dichas excepciones).<\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_24.1' id='input_4_24_1' type='checkbox' value='1'   aria-labelledby=\"input_4_24_1_label gfield_label_4_24\"  aria-invalid=\"false\"   \/> <label id='input_4_24_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_24_1' ><span class='gform-field-label__text'>Por la presente, solicito la limitaci\u00f3n del uso y la divulgaci\u00f3n de la siguiente informaci\u00f3n personal que ha recopilado sobre m\u00ed. (Reconozco que la informaci\u00f3n personal que solicito que se limite puede estar sujeta a varias excepciones y que usted me informar\u00e1 si mi solicitud no puede ser atendida debido a dichas excepciones).<\/span><\/label><input type='hidden' name='input_24.2' value='Por la presente, solicito la limitaci\u00f3n del uso y la divulgaci\u00f3n de la siguiente informaci\u00f3n personal que ha recopilado sobre m\u00ed. (Reconozco que la informaci\u00f3n personal que solicito que se limite puede estar sujeta a varias excepciones y que usted me informar\u00e1 si mi solicitud no puede ser atendida debido a dichas excepciones).' class='gform_hidden' \/><input type='hidden' name='input_24.3' value='1' class='gform_hidden' \/><\/div><\/li><li id=\"field_4_25\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"><label id='gfield_label_4_25' class='gfield_label gform-field-label' for='input_4_25'><span class='gform-field-label__text'>Solicitar la limitaci\u00f3n del uso y divulgaci\u00f3n de la siguiente informaci\u00f3n personal:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_25' id='input_4_25' class='textarea large'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_4_12\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"7eb98949\" data-field-span=\"12\"><label id='gfield_label_4_12' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Por la presente, solicito la eliminaci\u00f3n de la siguiente informaci\u00f3n personal que se ha recopilado sobre m\u00ed. (Reconozco que la informaci\u00f3n que solicito que se elimine puede estar sujeta a varias excepciones y que usted me informar\u00e1 si mi solicitud no puede cumplirse como resultado de esas excepciones).<\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_12.1' id='input_4_12_1' type='checkbox' value='1'   aria-labelledby=\"input_4_12_1_label gfield_label_4_12\"  aria-invalid=\"false\"   \/> <label id='input_4_12_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_12_1' ><span class='gform-field-label__text'>Por la presente, solicito la eliminaci\u00f3n de la siguiente informaci\u00f3n personal que se ha recopilado sobre m\u00ed. (Reconozco que la informaci\u00f3n que solicito que se elimine puede estar sujeta a varias excepciones y que usted me informar\u00e1 si mi solicitud no puede cumplirse como resultado de esas excepciones).<\/span><\/label><input type='hidden' name='input_12.2' value='Por la presente, solicito la eliminaci\u00f3n de la siguiente informaci\u00f3n personal que se ha recopilado sobre m\u00ed. (Reconozco que la informaci\u00f3n que solicito que se elimine puede estar sujeta a varias excepciones y que usted me informar\u00e1 si mi solicitud no puede cumplirse como resultado de esas excepciones).' class='gform_hidden' \/><input type='hidden' name='input_12.3' value='1' class='gform_hidden' \/><\/div><\/li><li id=\"field_4_21\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"7a24d1f4\" data-field-span=\"12\"><label id='gfield_label_4_21' class='gfield_label gform-field-label' for='input_4_21'><span class='gform-field-label__text'>Informaci\u00f3n personal que se solicita eliminar:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_21' id='input_4_21' class='textarea large'  aria-describedby=\"gfield_description_4_21\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_4_21'>Informaci\u00f3n personal que se solicita eliminar:<\/div><\/li><li id=\"field_4_26\" class=\"gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"c73e306f\" data-field-span=\"12\"><label id='gfield_label_4_26' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Por la presente, deseo corregir la informaci\u00f3n personal inexacta<\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_26.1' id='input_4_26_1' type='checkbox' value='1'   aria-labelledby=\"input_4_26_1_label gfield_label_4_26\"  aria-invalid=\"false\"   \/> <label id='input_4_26_1_label' class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_4_26_1' ><span class='gform-field-label__text'>Por la presente, deseo corregir la informaci\u00f3n personal inexacta<\/span><\/label><input type='hidden' name='input_26.2' value='Por la presente, deseo corregir la informaci\u00f3n personal inexacta' class='gform_hidden' \/><input type='hidden' name='input_26.3' value='1' class='gform_hidden' \/><\/div><\/li><li id=\"field_4_27\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"29368537\" data-field-span=\"12\"><label id='gfield_label_4_27' class='gfield_label gform-field-label' for='input_4_27'><span class='gform-field-label__text'>La informaci\u00f3n personal inexacta es:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_27' id='input_4_27' class='textarea large'  aria-describedby=\"gfield_description_4_27\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_4_27'>La informaci\u00f3n personal inexacta es:<\/div><\/li><li id=\"field_4_28\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"9f173686\" data-field-span=\"12\"><label id='gfield_label_4_28' class='gfield_label gform-field-label' for='input_4_28'><span class='gform-field-label__text'>La informaci\u00f3n personal correcta es:<\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_28' id='input_4_28' class='textarea large'  aria-describedby=\"gfield_description_4_28\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_4_28'>La informaci\u00f3n personal correcta es:<\/div><\/li><li id=\"field_4_13\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\" data-group-id=\"cb12f242\" data-field-span=\"12\"><label id='gfield_label_4_13' class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Fecha<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div id='input_4_13' class='ginput_container ginput_complex gform-grid-row'><div class=\"clear-multi\"><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_4_13_1_container'><label for='input_4_13_1' id='input_4_13_1_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Mes<\/label><select name='input_13[]' id='input_4_13_1'   aria-required='true'   aria-labelledby=\"input_4_13_1_label gfield_label_4_13\" ><option value=''>Mes<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_4_13_2_container'><label for='input_4_13_2' id='input_4_13_2_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>D\u00eda<\/label><select name='input_13[]' id='input_4_13_2'   aria-required='true'  ><option value=''>D\u00eda<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_4_13_3_container'><label for='input_4_13_3' id='input_4_13_3_label' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>A\u00f1o<\/label><select name='input_13[]' id='input_4_13_3'   aria-required='true'  ><option value=''>A\u00f1o<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><\/div><\/div><\/li><li id=\"field_4_18\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\" data-group-id=\"c2c2e359\" data-field-span=\"12\"><label id='gfield_label_4_18' class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Certificaci\u00f3n de precisi\u00f3n<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_4_18'><li class='gchoice gchoice_4_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='Por la presente certifico que, a mi leal saber y entender, la informaci\u00f3n proporcionada es verdadera y precisa.'  id='choice_4_18_1'    aria-labelledby=\"label_4_18_1 gfield_label_4_18\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_4_18_1' id='label_4_18_1' class='gform-field-label gform-field-label--type-inline'>Por la presente certifico que, a mi leal saber y entender, la informaci\u00f3n proporcionada es verdadera y precisa.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><\/ul><\/div>\n        <div class='gform-footer gform_footer top_label'> <button type='submit' id='gform_submit_button_4' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' >Submit<\/button> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_4' value='postback' 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