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<!DOCTYPE html> <html lang="es"> <head><script type="text/javascript" src="/_static/js/bundle-playback.js?v=HxkREWBo" charset="utf-8"></script> <script type="text/javascript" src="/_static/js/wombat.js?v=txqj7nKC" charset="utf-8"></script> <script>window.RufflePlayer=window.RufflePlayer||{};window.RufflePlayer.config={"autoplay":"on","unmuteOverlay":"hidden"};</script> <script type="text/javascript" src="/_static/js/ruffle/ruffle.js"></script> <script type="text/javascript"> __wm.init("https://web.archive.org/web"); __wm.wombat("https://sgs.transparencia.gob.sv/information_requests/new","20190705035922","https://web.archive.org/","web","/_static/", "1562299162"); </script> <link rel="stylesheet" type="text/css" href="/_static/css/banner-styles.css?v=S1zqJCYt" /> <link rel="stylesheet" type="text/css" href="/_static/css/iconochive.css?v=3PDvdIFv" />  <title> Sistema de Gestión de Solicitudes - El Salvador </title> <meta charset="utf-8"> <meta content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no, minimal-ui" name="viewport"> <meta content="yes" name="apple-mobile-web-app-capable"> <link href="/web/20190705035922im_/https://sgs.transparencia.gob.sv/images/favicon.png" rel="shortcut icon" sizes="128x128"> <link href="/web/20190705035922im_/https://sgs.transparencia.gob.sv/images/favicon.png" rel="apple-touch-icon" sizes="128x128"> <link href="/web/20190705035922im_/https://sgs.transparencia.gob.sv/images/favicon.png" rel="apple-touch-icon-precomposed" sizes="128x128"> <link rel="stylesheet" media="screen" href="/web/20190705035922cs_/https://sgs.transparencia.gob.sv/assets/application-a452e78d14316d99a2229b5022c85c101b9ebdbf0f65ca01e726bf31b7f289d1.css"/> <script src="https://web.archive.org/web/20190705035922js_/https://www.gstatic.com/charts/loader.js"></script> <script src="/web/20190705035922js_/https://sgs.transparencia.gob.sv/assets/application-8c2a15b60f4885fb0ccb7018c55f1e52138cb9d37b5f623a0cbce17b598c993a.js"></script> <meta name="csrf-param" content="authenticity_token"/> <meta name="csrf-token" content="/751wX65joCA6T9YhtjTWDdUz7nni8D/JYBjDm++g0FchmSG7NIqcionLo0/9vp73Rm6ExsG5xhPz6+cn8NUOw=="/> </head> <body> <header class="site-header" id="site-header"> <div id="top-bar"> <div class="container"> <div class="iaipFlex"> <div class="iaipFlexMain"> <a href="/web/20190705035922/https://sgs.transparencia.gob.sv/information_requests/new?class="><span> Sistema de Gestión de Solicitudes </span>  </a></div> <div class="xsPaddT-20 lgPaddT-0 xsPaddL-20"> <a target="_blank" class="" href="https://web.archive.org/web/20190705035922/https://iaip.gob.sv/"><img src="/web/20190705035922im_/https://sgs.transparencia.gob.sv/assets/iaip-675ba3cd5613924084210cc5546a2cf0f00a6c4cf7cfda44d4762d0bf1508863.png" alt="Iaip"/> </a></div> </div> </div> </div> </header> <main> <div class="container"> <div class="wrapper"> <div class="row align-center"> <div class="columns large-20 small-24"> <div class="container"> <form class="new_item" id="new_item" enctype="multipart/form-data" action="https://web.archive.org/web/20190705035922/https://sgs.transparencia.gob.sv/information_requests" accept-charset="UTF-8" method="post"><input name="utf8" type="hidden" value="✓"/><input type="hidden" name="authenticity_token" value="m+V7mBTEsbvvtBsq9g1IBjnSj+5sgXTG0Z7JggcqWG443Wrfhq8VSUV6Cv9PI2El05/6RJAMUyG70QUQ91ePFA=="/><div class="form"> <h1> Solicitud de información </h1> <br> <h2> Solicite información en cualquier institución del Órgano Ejecutivo haciendo uso de la Ley de Acceso a la Información Pública (LAIP) a través de nuestra aplicación en línea. El proceso es sencillo y se puede hacer desde cualquier lugar con una conexión a internet. </h2> <ol> <li>Llene el formulario en línea.</li> <li>Revise su correo electrónico y active su solicitud para que sea procesada.</li> <li>En caso de que solicite recibir la información por correo electrónico deberá adjuntar su documento.</li> <li>Una vez activada recibirá un correo electrónico del Oficial de Información indicando la fecha de entrega.</li> </ol> <div class="callout small primary"> <h5>Seleccione el tipo de información que desea solicitar</h5> </div> <br> <div class="row"> <div class="medium-5 small-11 columns"> <a class="button extended" id="form-normal" href="#">Información pública</a> </div> <div class="medium-5 medium-offset-1 small-11 small-offset-1 columns"> <a class="button hollow primary extended" id="form-personal" href="https://web.archive.org/web/20190705035922/https://sgs.transparencia.gob.sv/information_requests/new_personal">Información personal</a> </div> </div> <br> <br> <input value="normal" type="hidden" name="item[request_type]" id="item_request_type"/> <div class="public-information-wrapper"> <h2> Información general </h2> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_nationality">Nacionalidad</label></div> <div class="columns medium-18 small-23"> <div class="row"> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="item_salvadorian"><input id="information_request_salvadorian" type="radio" value="salvadorian" name="item[nationality]"/> <label for="information_request_salvadorian">Salvadoreña</label> </label></div> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="item_foreign"><input id="information_request_foreign" type="radio" value="foreign" name="item[nationality]"/> <label for="information_request_foreign">Extranjera</label> </label></div> </div> </div> </div> </div> <div class="nationality-container" style="display: none;"> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_nationality_name">Nacionalidad</label></div> <div class="columns medium-18 small-23"><select name="item[nationality_name]" id="item_nationality_name"><option value="">Seleccione</option> <option value="1">Afgana</option> <option value="2">Albanesa</option> <option value="3">Alemana</option> <option value="4">Alto volteña</option> <option value="5">Andorrana</option> <option value="6">Angoleña</option> <option value="7">Argelina</option> <option value="8">Argentina</option> <option value="9">Australiana</option> <option value="10">Austriaca</option> <option value="11">Bahamesa</option> <option value="12">Bahreina</option> <option value="13">Bangladesha</option> <option value="14">Barbadesa</option> <option value="15">Belga</option> <option value="16">BeliceÑa</option> <option value="17">Bermudesa</option> <option value="18">Birmana</option> <option value="19">Boliviana</option> <option value="20">Botswanesa</option> <option value="21">BrasileÑa</option> <option value="22">Bulgara</option> <option value="23">Burundesa</option> <option value="24">Butana</option> <option value="25">Camboyana</option> <option value="26">Camerunesa</option> <option value="27">Canadiense</option> <option value="28">Centroafricana</option> <option value="29">Chadeña</option> <option value="30">Checoslovaca</option> <option value="31">Chilena</option> <option value="32">China</option> <option value="33">Chipriota</option> <option value="34">Colombiana</option> <option value="35">Congoleña</option> <option value="36">Costarricense</option> <option value="37">Cubana</option> <option value="38">Dahoneya</option> <option value="39">Danes</option> <option value="40">Dominicana</option> <option value="41">Ecuatoriana</option> <option value="42">Egipcia</option> <option value="43">Emirata</option> <option value="44">Escosesa</option> <option value="45">Eslovaca</option> <option value="46">Española</option> <option value="47">Estona</option> <option value="48">Etiope</option> <option value="49">Fijena</option> <option value="50">Filipina</option> <option value="51">Finlandesa</option> <option value="52">Francesa</option> <option value="53">Gabiana</option> <option value="54">Gabona</option> <option value="55">Galesa</option> <option value="56">Ghanesa</option> <option value="57">Granadeña</option> <option value="58">Griega</option> <option value="59">Guatemalteca</option> <option value="61">Guinesa</option> <option value="60">Guinesa Ecuatoriana</option> <option value="62">Guyanesa</option> <option value="63">Haitiana</option> <option value="64">Holandesa</option> <option value="65">Hondureña</option> <option value="66">Hungara</option> <option value="67">India</option> <option value="68">Indonesa</option> <option value="69">Inglesa</option> <option value="70">Iraki</option> <option value="71">Irani</option> <option value="72">Irlandesa</option> <option value="73">Islandesa</option> <option value="74">Israeli</option> <option value="75">Italiana</option> <option value="76">Jamaiquina</option> <option value="77">Japonesa</option> <option value="78">Jordana</option> <option value="79">Katensa</option> <option value="80">Keniana</option> <option value="81">Kuwaiti</option> <option value="82">Laosiana</option> <option value="83">Leonesa</option> <option value="84">Lesothensa</option> <option value="85">Letonesa</option> <option value="86">Libanesa</option> <option value="88">Libeña</option> <option value="87">Liberiana</option> <option value="89">Liechtenstein</option> <option value="90">Lituana</option> <option value="91">Luxemburgo</option> <option value="92">Madagascar</option> <option value="93">Malaca</option> <option value="94">Malawi</option> <option value="95">Maldivas</option> <option value="96">Mali</option> <option value="97">Maltesa</option> <option value="98">Marfilesa</option> <option value="99">Marroqui</option> <option value="100">Mauricio</option> <option value="101">Mauritana</option> <option value="102">Mexicana</option> <option value="103">Monaco</option> <option value="104">Mongolesa</option> <option value="105">Nauru</option> <option value="106">Neozelandesa</option> <option value="107">Nepalesa</option> <option value="108">Nicaraguense</option> <option value="109">Nigerana</option> <option value="110">Nigeriana</option> <option value="111">Norcoreana</option> <option value="112">Norirlandesa</option> <option value="113">Norteamericana</option> <option value="114">Noruega</option> <option value="115">Omana</option> <option value="116">Pakistani</option> <option value="117">Panameña</option> <option value="118">Paraguaya</option> <option value="119">Peruana</option> <option value="120">Polaca</option> <option value="121">Portoriqueña</option> <option value="122">Portuguesa</option> <option value="123">Rhodesiana</option> <option value="124">Ruanda</option> <option value="125">Rumana</option> <option value="126">Rusa</option> <option value="127">Salvadoreña</option> <option value="128">Samoa Occidental</option> <option value="129">San marino</option> <option value="130">Saudi</option> <option value="131">Senegalesa</option> <option value="132">Sikkim</option> <option value="133">Singapur</option> <option value="134">Siria</option> <option value="135">Somalia</option> <option value="136">Sovietica</option> <option value="137">Sri Lanka</option> <option value="138">Suazilandesa</option> <option value="139">Sudafricana</option> <option value="140">Sudanesa</option> <option value="141">Sueca</option> <option value="142">Suiza</option> <option value="143">Surcoreana</option> <option value="144">Tailandesa</option> <option value="145">Tanzana</option> <option value="146">Tonga</option> <option value="147">Tongo</option> <option value="148">Trinidad y Tobago</option> <option value="149">Tunecina</option> <option value="150">Turca</option> <option value="151">Ugandesa</option> <option value="152">Uruguaya</option> <option value="153">Vaticano</option> <option value="154">Venezolana</option> <option value="155">Vietnamita</option> <option value="156">Yemen Rep Arabe</option> <option value="157">Yemen Rep Dem</option> <option value="158">Yugoslava</option> <option value="159">Zaire</option></select></div> </div> </div> </div> <br> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_institution_id">Institución</label></div> <div class="columns medium-18 small-23"><select name="item[institution_id]" id="item_institution_id"><option value="">Seleccione</option> <option value="13">Academia Nacional de Seguridad Pública (ANSP)</option> <option value="48">Administración Nacional de Acueductos y Alcantarillados (ANDA)</option> <option value="264">Alcaldía Municipal de San Miguel (Alc. de San Miguel)</option> <option value="266">Alcaldía Municipal de San Pedro Perulapán (AMSPP)</option> <option value="51">Autoridad de Aviación Civil de El Salvador (AAC)</option> <option value="54">Autoridad Marítima Portuaria (AMP)</option> <option value="73">Banco Central de Reserva de El Salvador (BCR)</option> <option value="70">Banco de Desarrollo de El Salvador (BANDESAL)</option> <option value="72">Banco de Fomento Agropecuario (BFA)</option> <option value="17">Caja Mutual de los Empleados del Ministerio de Educación (CAJA MINED)</option> <option value="59">Centro Farmacéutico de la Fuerza Armada (CEFAFA)</option> <option value="30">Centro Internacional de Ferias y Convenciones (CIFCO)</option> <option value="39">Centro Nacional de Registros (CNR)</option> <option value="45">Centro Nacional de Tecnología Agrícola y Forestal, Enrique Álvarez Córdova (CENTA)</option> <option value="34">Comisión Ejecutiva Hidroeléctrica del Río Lempa (CEL)</option> <option value="50">Comision Ejecutiva Portuaria Autonoma (CEPA)</option> <option value="42">Comisión Nacional de la Micro y Pequeña Empresa (CONAMYPE)</option> <option value="32">Consejo de Vigilancia de la Profesión de Contaduría Pública y Auditoría (CVPCPA)</option> <option value="74">Consejo Nacional de Atención Integral a la Persona con Discapacidad (CONAIPD)</option> <option value="75">Consejo Nacional de Calidad (CNC)</option> <option value="31">Consejo Nacional de Ciencia y Tecnología (CONACYT)</option> <option value="65">Consejo Nacional de Energía (CNE)</option> <option value="19">Consejo Nacional de la Niñez y de la Adolescencia (CONNA)</option> <option value="117">Consejo Salvadoreño de la Agroindustria Azucarera (CONSAA)</option> <option value="33">Consejo Salvadoreño del Café (CSC)</option> <option value="21">Consejo Superior de Salud Pública (CSSP)</option> <option value="38">Corporación Salvadoreña de Inversiones (CORSAIN)</option> <option value="35">Corporación Salvadoreña de Turismo (CORSATUR)</option> <option value="41">Defensoría del Consumidor (DC)</option> <option value="231">Dirección General de Aduanas (DGA)</option> <option value="68">Dirección General de Centros Penales (DGCP)</option> <option value="265">Dirección General de Impuestos Internos del Ministerio de Hacienda (DGII)</option> <option value="62">Dirección General de Migración y Extranjería (DGME)</option> <option value="76">Dirección Nacional de Medicamentos (DNM)</option> <option value="46">Escuela Nacional de Agricultura (ENA)</option> <option value="56">Fondo Ambiental de El Salvador (FONAES)</option> <option value="53">Fondo de Conservación Víal (FOVIAL)</option> <option value="4">Fondo de Inversión Nacional en Electrificación y Telefonía / Fondo de Inversión Social para el Desarrollo Local de El Salvador (FINET/FISDL)</option> <option value="28">Fondo de Proteccion de Lisiados y Discapacitados a Consecuencia del Conflicto Armado (FOPROLYD)</option> <option value="64">Fondo de Saneamiento y Fortalecimiento Financiero (FOSAFFI)</option> <option value="63">Fondo Especial de los Recursos provenientes de la Privatización de ANTEL (FANTEL)</option> <option value="52">Fondo Nacional de Vivienda Popular (FONAVIPO)</option> <option value="199">Fondo para la Atención a las Víctimas de Accidentes de Tránsito (FONAT)</option> <option value="61">Fondo Salvadoreño para Estudios de Preinversión (FOSEP)</option> <option value="49">Fondo Social para la Vivienda (FSV)</option> <option value="5">Fondo Solidario para la Familia Microempresaria (FOSOFAMILIA)</option> <option value="23">Fondo Solidario para la Salud (FOSALUD)</option> <option value="227">Inspectoría General de Seguridad Pública (IGSP)</option> <option value="116">Institución de Prueba (TEST)</option> <option value="66">Instituto de Garantía de Depósitos (IGD)</option> <option value="60">Instituto de Legalización de la Propiedad (ILP)</option> <option value="69">Instituto de Previsión Social de la Fuerza Armada (IPSFA)</option> <option value="170">Instituto Especializado de Educación Superior para la Formación Diplomática (IEESFORD)</option> <option value="200">Instituto Nacional de la Juventud (INJUVE)</option> <option value="2">Instituto Nacional de los Deportes de El Salvador (INDES)</option> <option value="8">Instituto Nacional de Pensiones de los Empleados Públicos (INPEP)</option> <option value="71">Instituto Salvadoreño de Bienestar Magisterial (ISBM)</option> <option value="12">Instituto Salvadoreño de Desarrollo Municipal (ISDEM)</option> <option value="25">Instituto Salvadoreño de Fomento Cooperativo (INSAFOCOOP)</option> <option value="26">Instituto Salvadoreño de Formación Profesional (INSAFORP)</option> <option value="27">Instituto Salvadoreño del Seguro Social (ISSS)</option> <option value="22">Instituto Salvadoreño de Rehabilitación Integral (ISRI)</option> <option value="44">Instituto Salvadoreño de Transformación Agraria (ISTA)</option> <option value="58">Instituto Salvadoreño de Turismo (ISTU)</option> <option value="3">Instituto Salvadoreño para el Desarrollo de la Mujer (ISDEMU)</option> <option value="18">Instituto Salvadoreño Para el Desarrollo Integral de la Niñez y la Adolescencia (ISNA)</option> <option value="7">Lotería Nacional de Beneficencia (LNB)</option> <option value="43">Ministerio de Agricultura y Ganadería (MAG)</option> <option value="263">Ministerio de Cultura (MINCU)</option> <option value="29">Ministerio de Economía (MINEC)</option> <option value="16">Ministerio de Educación (MINED)</option> <option value="14">Ministerio de Gobernación y Desarrollo Territorial (MIGOBDT)</option> <option value="6">Ministerio de Hacienda (MH)</option> <option value="15">Ministerio de Justicia y Seguridad Publica (MJSP)</option> <option value="11">Ministerio de la Defensa Nacional (MDN)</option> <option value="55">Ministerio de Medio Ambiente y Recursos Naturales (MARN)</option> <option value="47">Ministerio de Obras Pública, Transporte, Vivienda y Desarrollo Urbano (MOP)</option> <option value="10">Ministerio de Relaciones Exteriores (RREE)</option> <option value="20">Ministerio de Salud (MINSAL)</option> <option value="24">Ministerio de Trabajo y Previsión Social (MTPS)</option> <option value="57">Ministerio de Turismo (MITUR)</option> <option value="82">Oficina de Planificación del Área Metropolitana de San Salvador (OPAMSS)</option> <option value="93">Organismo Promotor de Exportaciones e Inversiones de El Salvador (PROESA)</option> <option value="67">Policía Nacional Civil (PNC)</option> <option value="9">Presidencia de la República (CAPRES)</option> <option value="83">Procuraduría General de la República (PGR)</option> <option value="1">Registro Nacional de las Personas Naturales (RNPN)</option> <option value="40">Superintendencia de Competencia (SC)</option> <option value="37">Superintendencia del Sistema Financiero (SSF)</option> <option value="36">Superintendencia General de Electricidad y Telecomunicaciones (SIGET)</option> <option value="92">Viceministerio de Transporte (VMT)</option></select></div>  </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_residence">Residencia</label></div> <div class="columns medium-18 small-23"> <div class="row"> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="item_el_salvador"><input id="information_request_el_salvador" type="radio" value="el_salvador" name="item[residence]"/> <label for="information_request_el_salvador">El salvador</label> </label></div> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="item_other"><input id="information_request_other" type="radio" value="other" name="item[residence]"/> <label for="information_request_other">Otra</label> </label></div> </div> </div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_entity_type">Tipo de persona</label></div> <div class="columns medium-18 small-23"> <div class="row"> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="item_natural"><input id="information_request_natural" type="radio" value="natural" name="item[entity_type]"/> <label for="information_request_natural">Persona natural</label> </label></div> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="item_legal"><input id="information_request_legal" type="radio" value="legal" name="item[entity_type]"/> <label for="information_request_legal">Persona jurídica</label> </label></div> </div> </div> </div> </div> <div class="control entity_type_legal_dependent"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_legal_representative">Representante legal</label></div> <div class="columns medium-18 small-23"><input type="text" name="item[legal_representative]" id="item_legal_representative"/></div> </div> </div> <br> <div class="control entity_type_legal_dependent"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_legal_representative_doc">Documento de representación legal</label></div> <div class="columns medium-18 small-23"> <input type="file" name="item[legal_representative_doc]" id="item_legal_representative_doc"/> <br> <i class="muted"> 5MB , JPG / PNG / DOC / DOCX / PDF </i> </div> </div> </div> <br> <h2> Datos del solicitante </h2> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_firstname">Nombres</label></div> <div class="columns medium-18 small-23"><input type="text" name="item[firstname]" id="item_firstname"/></div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_lastname">Apellidos</label></div> <div class="columns medium-18 small-23"><input type="text" name="item[lastname]" id="item_lastname"/></div> </div> </div> <div class="control entity_type_dependent"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_birthday">Fecha de nacimiento</label></div> <div class="columns medium-18 small-23"><select id="item_birthday_3i" name="item[birthday(3i)]" class="date"> <option value="">Día</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> <select id="item_birthday_2i" name="item[birthday(2i)]" class="date"> <option value="">Mes</option> <option value="1">enero</option> <option value="2">febrero</option> <option value="3">marzo</option> <option value="4">abril</option> <option value="5">mayo</option> <option value="6">junio</option> <option value="7">julio</option> <option value="8">agosto</option> <option value="9">septiembre</option> <option value="10">octubre</option> <option value="11">noviembre</option> <option value="12">diciembre</option> </select> <select id="item_birthday_1i" name="item[birthday(1i)]" class="date"> <option value="">Año</option> <option value="1930">1930</option> <option value="1931">1931</option> <option value="1932">1932</option> <option value="1933">1933</option> <option value="1934">1934</option> <option value="1935">1935</option> <option value="1936">1936</option> <option value="1937">1937</option> <option value="1938">1938</option> <option value="1939">1939</option> <option value="1940">1940</option> <option value="1941">1941</option> <option value="1942">1942</option> <option value="1943">1943</option> <option value="1944">1944</option> <option value="1945">1945</option> <option value="1946">1946</option> <option value="1947">1947</option> <option value="1948">1948</option> <option value="1949">1949</option> <option value="1950">1950</option> <option value="1951">1951</option> <option value="1952">1952</option> <option value="1953">1953</option> <option value="1954">1954</option> <option value="1955">1955</option> <option value="1956">1956</option> <option value="1957">1957</option> <option value="1958">1958</option> <option value="1959">1959</option> <option value="1960">1960</option> <option value="1961">1961</option> <option value="1962">1962</option> <option value="1963">1963</option> <option value="1964">1964</option> <option value="1965">1965</option> <option value="1966">1966</option> <option value="1967">1967</option> <option value="1968">1968</option> <option value="1969">1969</option> <option value="1970">1970</option> <option value="1971">1971</option> <option value="1972">1972</option> <option value="1973">1973</option> <option value="1974">1974</option> <option value="1975">1975</option> <option value="1976">1976</option> <option value="1977">1977</option> <option value="1978">1978</option> <option value="1979">1979</option> <option value="1980">1980</option> <option value="1981">1981</option> <option value="1982">1982</option> <option value="1983">1983</option> <option value="1984">1984</option> <option value="1985">1985</option> <option value="1986">1986</option> <option value="1987">1987</option> <option value="1988">1988</option> <option value="1989">1989</option> <option value="1990">1990</option> <option value="1991">1991</option> <option value="1992">1992</option> <option value="1993">1993</option> <option value="1994">1994</option> <option value="1995">1995</option> <option value="1996">1996</option> <option value="1997">1997</option> <option value="1998">1998</option> <option value="1999">1999</option> <option value="2000">2000</option> <option value="2001">2001</option> <option value="2002">2002</option> <option value="2003">2003</option> <option value="2004">2004</option> <option value="2005">2005</option> <option value="2006">2006</option> <option value="2007">2007</option> <option value="2008">2008</option> <option value="2009">2009</option> </select> </div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_gender">Género</label></div> <div class="columns medium-18 small-23"> <div class="row"> <div class="medium-6 small-10 columns"> <label class="radio-inline" for="item_female"><input id="information_request_female" type="radio" value="female" name="item[gender]"/> <label for="information_request_female">Femenino</label> </label></div> <div class="medium-6 small-10 columns"> <label class="radio-inline" for="item_male"><input id="information_request_male" type="radio" value="male" name="item[gender]"/> <label for="information_request_male">Masculino</label> </label></div> </div> </div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_email">Correo electrónico</label></div> <div class="columns medium-18 small-23"><input type="text" name="item[email]" id="item_email"/></div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_phone">Teléfono</label></div> <div class="columns medium-18 small-23"><input type="text" name="item[phone]" id="item_phone"/></div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_cellular">Celular</label></div> <div class="columns medium-18 small-23"><input type="text" name="item[cellular]" id="item_cellular"/></div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_fax">Fax</label></div> <div class="columns medium-18 small-23"><input type="text" name="item[fax]" id="item_fax"/></div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_address">Dirección</label></div> <div class="columns medium-18 small-23"><textarea rows="2" name="item[address]" id="item_address"></textarea></div> </div> </div> <div class="control entity_type_dependent"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_educational_level">Nivel educativo</label></div> <div class="columns medium-18 small-23"><select name="item[educational_level]" id="item_educational_level"><option value="">Seleccione</option> <option value="unknown">No especificó su inf. académica</option> <option value="neither">Sin educación formal</option> <option value="primary">Primaria (Hasta sexto grado)</option> <option value="secondary">Secundaria (Tercer ciclo)</option> <option value="highschool">Bachillerato</option> <option value="university">Universitario</option> <option value="postgrade">Postgrado</option></select></div> </div> </div> <div class="control entity_type_dependent"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_occupation_id">Ocupación</label></div> <div class="columns medium-18 small-23"><select name="item[occupation_id]" id="item_occupation_id"><option value="">Seleccione</option> <option value="2">Abogada/ Abogado</option> <option value="1">Administradora/ Administrador</option> <option value="46">Agricultor</option> <option value="42">Agrónomos</option> <option value="3">Arquitecta/ Arquitecto</option> <option value="4">Artista</option> <option value="5">Asesora/ Asesor</option> <option value="6">Asistente de oficina</option> <option value="7">Auditora/ Auditor</option> <option value="44">Biólogo</option> <option value="8">Comunicadora/ Comunicador Institucional</option> <option value="9">Conserje</option> <option value="10">Consultora/ Consultor</option> <option value="11">Contadora/ Contador</option> <option value="40">Costurera</option> <option value="12">Directora/ Director</option> <option value="13">Diseñadora/ Diseñador</option> <option value="14">Docente</option> <option value="15">Economista</option> <option value="38">Electricista</option> <option value="37">Empleado/ Empleada</option> <option value="50">Empleado Público</option> <option value="16">Empresaria/ Empresario</option> <option value="17">Enfermera/ Enfermero</option> <option value="18">Estudiante</option> <option value="47">Ganadero</option> <option value="19">Gerente</option> <option value="49">Importador</option> <option value="20">Informática/informático</option> <option value="41">Ing. Agrónomo</option> <option value="21">Ingeniera/ Ingeniero</option> <option value="43">Ing. Químico</option> <option value="22">Investigador/Investigadora</option> <option value="23">Médica/ Médico</option> <option value="45">Médico Veterinario</option> <option value="24">Mercadóloga/ Mercadólogo</option> <option value="55">Militar</option> <option value="25">Motorista</option> <option value="36">Oficios del hogar/ Oficios domésticos</option> <option value="26">Operadora/ Operador</option> <option value="35">Operario/ Operaria</option> <option value="27">Otros</option> <option value="52">Pensionado</option> <option value="28">Periodista</option> <option value="48">Productor</option> <option value="29">Promotora/Promotor Social</option> <option value="30">Psicóloga/ Psicólogo</option> <option value="31">Publicista</option> <option value="51">Químico-farmacéutico</option> <option value="32">Recepcionista</option> <option value="54">Representante de ONG</option> <option value="53">Representante de Sindicato</option> <option value="39">Sastre</option> <option value="33">Secretaria/Secretario</option> <option value="34">Vendedora/ Vendedor (Comerciante)</option></select></div> </div> </div> <div class="control residence_dependent"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_state_id">Departamento</label></div> <div class="columns medium-18 small-23"><select data-dependent="" data-target="select-city" name="item[state_id]" id="item_state_id"><option value="">Seleccione</option> <option value="1">Ahuachapán</option> <option value="2">Cabañas</option> <option value="3">Chalatenango</option> <option value="4">Cuscatlán</option> <option value="5">La Libertad</option> <option value="6">La Paz</option> <option value="7">La Unión</option> <option value="8">Morazán</option> <option value="9">San Miguel</option> <option value="10">San Salvador</option> <option value="11">San Vicente</option> <option value="12">Santa Ana</option> <option value="13">Sonsonate</option> <option value="14">Usulután</option></select></div> </div> </div> <div class="control residence_dependent"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_city_id">Municipio</label></div> <div class="columns medium-18 small-23"><select class="select-city" name="item[city_id]" id="item_city_id"><option value="">Seleccione</option> <optgroup label="Ahuachapán"><option value="1">Ahuachapán</option> <option value="2">Jujutla</option> <option value="3">Atiquizaya</option> <option value="4">Concepción de Ataco</option> <option value="5">El Refugio</option> <option value="6">Guaymango</option> <option value="7">Apaneca</option> <option value="8">San Francisco Menéndez</option> <option value="9">San Lorenzo</option> <option value="10">San Pedro Puxtla</option> <option value="11">Tacuba</option> <option value="12">Turín</option></optgroup><optgroup label="Cabañas"><option value="13">Cinquera</option> <option value="14">Villa Dolores</option> <option value="15">Guacotecti</option> <option value="16">Ilobasco</option> <option value="17">Jutiapa</option> <option value="18">San Isidro</option> <option value="19">Sensuntepeque</option> <option value="20">Tejutepeque</option> <option value="21">Victoria</option></optgroup><optgroup label="Chalatenango"><option value="22">Agua Caliente</option> <option value="23">Arcatao</option> <option value="24">Azacualpa</option> <option value="25">Chalatenango</option> <option value="26">Citalá</option> <option value="27">Comalapa</option> <option value="28">Concepción Quezaltepeque</option> <option value="29">Dulce Nombre de María</option> <option value="30">El Carrizal</option> <option value="31">El Paraíso</option> <option value="32">La Laguna</option> <option value="33">La Palma</option> <option value="34">La Reina</option> <option value="35">Las Vueltas</option> <option value="36">Nombre de Jesús</option> <option value="37">Nueva Concepción</option> <option value="38">Nueva Trinidad</option> <option value="39">Ojos de Agua</option> <option value="40">Potonico</option> <option value="41">San Antonio de la Cruz</option> <option value="42">San Antonio Los Ranchos</option> <option value="43">San Fernando</option> <option value="44">San Francisco Lempa</option> <option value="45">San Francisco Morazán</option> <option value="46">San Ignacio</option> <option value="47">San Isidro Labrador</option> <option value="48">San José Cancasque</option> <option value="49">San José Las Flores</option> <option value="50">San Luis del Carmen</option> <option value="51">San Miguel de Mercedes</option> <option value="52">San Rafael</option> <option value="53">Santa Rita</option> <option value="54">Tejutla</option></optgroup><optgroup label="Cuscatlán"><option value="55">Candelaria</option> <option value="56">Cojutepeque</option> <option value="57">El Carmen</option> <option value="58">El Rosario</option> <option value="59">Monte San Juan</option> <option value="60">Oratorio de Concepción</option> <option value="61">San Bartolomé Perulapía</option> <option value="62">San Cristóbal</option> <option value="63">San José Guayabal</option> <option value="64">San Pedro Perulapán</option> <option value="65">San Rafael Cedros</option> <option value="66">San Ramón</option> <option value="67">Santa Cruz Analquito</option> <option value="68">Santa Cruz Michapa</option> <option value="69">Suchitoto</option> <option value="70">Tenancingo</option></optgroup><optgroup label="La Libertad"><option value="71">Antiguo Cuscatlán</option> <option value="72">Chiltiupán</option> <option value="73">Ciudad Arce</option> <option value="74">Colón</option> <option value="75">Comasagua</option> <option value="76">Huizúcar</option> <option value="77">Jayaque</option> <option value="78">Jicalapa</option> <option value="79">La Libertad</option> <option value="80">Santa Tecla</option> <option value="81">Nuevo Cuscatlán</option> <option value="82">San Juan Opico</option> <option value="83">Quezaltepeque</option> <option value="84">Sacacoyo</option> <option value="85">San José Villanueva</option> <option value="86">San Matías</option> <option value="87">San Pablo Tacachico</option> <option value="88">Talnique</option> <option value="89">Tamanique</option> <option value="90">Teotepeque</option> <option value="91">Tepecoyo</option> <option value="92">Zaragoza</option></optgroup><optgroup label="La Paz"><option value="93">Cuyultitán</option> <option value="94">El Rosario</option> <option value="95">Jerusalén</option> <option value="96">Mercedes La Ceiba</option> <option value="97">Olocuilta</option> <option value="98">Paraíso de Osorio</option> <option value="99">San Antonio Masahuat</option> <option value="100">San Emigdio</option> <option value="101">San Francisco Chinameca</option> <option value="102">San Juan Nonualco</option> <option value="103">San Juan Talpa</option> <option value="104">San Juan Tepezontes</option> <option value="105">San Luis La Herradura</option> <option value="106">San Luis Talpa</option> <option value="107">San Miguel Tepezontes</option> <option value="108">San Pedro Masahuat</option> <option value="109">San Pedro Nonualco</option> <option value="110">San Rafael Obrajuelo</option> <option value="111">Santa María Ostuma</option> <option value="112">Santiago Nonualco</option> <option value="113">Tapalhuaca</option> <option value="114">Zacatecoluca</option></optgroup><optgroup label="La Unión"><option value="115">Anamorós</option> <option value="116">Bolívar</option> <option value="117">Concepción de Oriente</option> <option value="118">Conchagua</option> <option value="119">El Carmen</option> <option value="120">El Sauce</option> <option value="121">Intipucá</option> <option value="122">La Unión</option> <option value="123">Lislique</option> <option value="124">Meanguera del Golfo</option> <option value="125">Nueva Esparta</option> <option value="126">Pasaquina</option> <option value="127">Polorós</option> <option value="128">San Alejo</option> <option value="129">San José</option> <option value="130">Santa Rosa de Lima</option> <option value="131">Yayantique</option> <option value="132">Yucuayquín</option></optgroup><optgroup label="Morazán"><option value="133">Arambala</option> <option value="134">Cacaopera</option> <option value="135">Chilanga</option> <option value="136">Corinto</option> <option value="137">Delicias de Concepción</option> <option value="138">El Divisadero</option> <option value="139">El Rosario</option> <option value="140">Gualococti</option> <option value="141">Guatajiagua</option> <option value="142">Joateca</option> <option value="143">Jocoaitique</option> <option value="144">Jocoro</option> <option value="145">Lolotiquillo</option> <option value="146">Meanguera</option> <option value="147">Osicala</option> <option value="148">Perquín</option> <option value="149">San Carlos</option> <option value="150">San Fernando</option> <option value="151">San Francisco Gotera</option> <option value="152">San Isidro</option> <option value="153">San Simón</option> <option value="154">Sensembra</option> <option value="155">Sociedad</option> <option value="156">Torola</option> <option value="157">Yamabal</option> <option value="158">Yoloaiquín</option></optgroup><optgroup label="San Miguel"><option value="159">Carolina</option> <option value="160">Chapeltique</option> <option value="161">Chinameca</option> <option value="162">Chirilagua</option> <option value="163">Ciudad Barrios</option> <option value="164">Comacarán</option> <option value="165">El Tránsito</option> <option value="166">Lolotique</option> <option value="167">Moncagua</option> <option value="168">Nueva Guadalupe</option> <option value="169">Nuevo Edén de San Juan</option> <option value="170">Quelepa</option> <option value="171">San Antonio</option> <option value="172">San Gerardo</option> <option value="173">San Jorge</option> <option value="174">San Luis de la Reina</option> <option value="175">San Miguel</option> <option value="176">San Rafael</option> <option value="177">Sesori</option> <option value="178">Uluazapa</option></optgroup><optgroup label="San Salvador"><option value="179">Aguilares</option> <option value="180">Apopa</option> <option value="181">Ayutuxtepeque</option> <option value="182">Cuscatancingo</option> <option value="183">Delgado</option> <option value="184">El Paisnal</option> <option value="185">Guazapa</option> <option value="186">Ilopango</option> <option value="187">Mejicanos</option> <option value="188">Nejapa</option> <option value="189">Panchimalco</option> <option value="190">Rosario de Mora</option> <option value="191">San Marcos</option> <option value="192">San Martín</option> <option value="193">San Salvador</option> <option value="194">Santiago Texacuangos</option> <option value="195">Santo Tomás</option> <option value="196">Soyapango</option> <option value="197">Tonacatepeque</option></optgroup><optgroup label="San Vicente"><option value="198">Apastepeque</option> <option value="199">Guadalupe</option> <option value="200">San Cayetano Istepeque</option> <option value="201">San Esteban Catarina</option> <option value="202">San Ildefonso</option> <option value="203">San Lorenzo</option> <option value="204">San Sebastián</option> <option value="205">Santa Clara</option> <option value="206">Santo Domingo</option> <option value="207">San Vicente</option> <option value="208">Tecoluca</option> <option value="209">Tepetitán</option> <option value="210">Verapaz</option></optgroup><optgroup label="Santa Ana"><option value="211">Candelaria de la Frontera</option> <option value="212">Chalchuapa</option> <option value="213">Coatepeque</option> <option value="214">El Congo</option> <option value="215">El Porvenir</option> <option value="216">Masahuat</option> <option value="217">Metapán</option> <option value="218">San Antonio Pajonal</option> <option value="219">San Sebastián Salitrillo</option> <option value="220">Santa Ana</option> <option value="221">Santa Rosa Guachipilín</option> <option value="222">Santiago de la Frontera</option> <option value="223">Texistepeque</option></optgroup><optgroup label="Sonsonate"><option value="224">Acajutla</option> <option value="225">Armenia</option> <option value="226">Caluco</option> <option value="227">Cuisnahuat</option> <option value="228">Izalco</option> <option value="229">Juayúa</option> <option value="230">Nahuizalco</option> <option value="231">Nahulingo</option> <option value="232">Salcoatitán</option> <option value="233">San Antonio del Monte</option> <option value="234">San Julián</option> <option value="235">Santa Catarina Masahuat</option> <option value="236">Santa Isabel Ishuatán</option> <option value="237">Santo Domingo</option> <option value="238">Sonsonate</option> <option value="239">Sonzacate</option></optgroup><optgroup label="Usulután"><option value="240">Alegría</option> <option value="241">Berlín</option> <option value="242">California</option> <option value="243">Concepción Batres</option> <option value="244">El Triunfo</option> <option value="245">Ereguayquín</option> <option value="246">Estanzuelas</option> <option value="247">Jiquilisco</option> <option value="248">Jucuapa</option> <option value="249">Jucuarán</option> <option value="250">Mercedes Umaña</option> <option value="251">Nueva Granada</option> <option value="252">Ozatlán</option> <option value="253">Puerto El Triunfo</option> <option value="254">San Agustín</option> <option value="255">San Buenaventura</option> <option value="256">San Dionisio</option> <option value="257">San Francisco Javier</option> <option value="258">Santa Elena</option> <option value="259">Santa María</option> <option value="260">Santiago de María</option> <option value="261">Tecapán</option> <option value="262">Usulután</option></optgroup></select></div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_notification_mode">Como quiero que me notifiquen</label></div> <div class="columns medium-18 small-23"> <div class="row"> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="notification_mode_email"><input type="checkbox" name="notification_mode[]" id="notification_mode_" value="email"/> Correo electrónico </label></div> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="notification_mode_phone"><input type="checkbox" name="notification_mode[]" id="notification_mode_" value="phone"/> Teléfono </label></div> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="notification_mode_cellular"><input type="checkbox" name="notification_mode[]" id="notification_mode_" value="cellular"/> Celular </label></div> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="notification_mode_fax"><input type="checkbox" name="notification_mode[]" id="notification_mode_" value="fax"/> FAX </label></div> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="notification_mode_mail"><input type="checkbox" name="notification_mode[]" id="notification_mode_" value="mail"/> Correo nacional </label></div> <div class="medium-6 small-12 columns"> <label class="radio-inline" for="notification_mode_oir_uaip"><input type="checkbox" name="notification_mode[]" id="notification_mode_" value="oir_uaip"/> OIR-UAIP </label></div> </div> </div> </div> </div> <br> <h2>Información Solicitada</h2> <div> <i class="muted">Por favor, incluya, de uno a uno, cada uno de los elementos (requerimientos) que solicitará.</i> </div> <br> <div id="requirements"> <div class="nested-fields"> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_requirements_attributes_0_Requerimiento">Requerimiento</label></div> <div class="columns medium-18 small-23"> <textarea class="tinymce" rows="2" name="item[requirements_attributes][0][requested_information]" id="item_requirements_attributes_0_requested_information"></textarea> <script> tinyMCE.init({ selector: "textarea.tinymce", max_chars: 1000, // max. allowed chars setup: function (ed) { var allowedKeys = [8, 37, 38, 39, 40, 46]; // backspace, delete and cursor keys ed.on('keydown', function (e) { if (allowedKeys.indexOf(e.keyCode) != -1) return true; if (tinymce_getContentLength() + 1 > this.settings.max_chars) { e.preventDefault(); e.stopPropagation(); return false; } return true; }); ed.on('keyup', function (e) { tinymce_updateCharCounter(this, tinymce_getContentLength()); }); }, init_instance_callback: function () { // initialize counter div $('#' + this.id).prev().append('<div class="char_count" style="text-align:right"></div>'); tinymce_updateCharCounter(this, tinymce_getContentLength()); }, paste_preprocess: function (plugin, args) { var editor = tinymce.get(tinymce.activeEditor.id); var len = editor.contentDocument.body.innerHTML.length; var text = $(args.content).text(); if (len + text.length > editor.settings.max_chars) { alert('Supera el limite de' + editor.settings.max_chars + ' caracteres.'); args.content = ''; } else { tinymce_updateCharCounter(editor, len + text.length); } } }); function tinymce_updateCharCounter(el, len) { $('#' + el.id).prev().find('.char_count').text(len + '/' + el.settings.max_chars); } function tinymce_getContentLength() { return tinymce.get(tinymce.activeEditor.id).contentDocument.body.innerText.length; } </script> </div> </div> </div> <div class="remove-nested"> <input type="hidden" name="item[requirements_attributes][0][_destroy]" id="item_requirements_attributes_0__destroy" value="false"/><a class="remove_fields dynamic" href="#"><i class="material-icons">remove_circle_outline</i> Remover </a></div> </div> <div class="add-nested"> <a class="add_fields" data-association="requirement" data-associations="requirements" data-association-insertion-template="<div class='nested-fields'> <div class='control'> <div class='row align-middle align-justify'> <div class='columns medium-5 small-23'><label for="item_requirements_attributes_new_requirements_Requerimiento">Requerimiento</label></div> <div class='columns medium-18 small-23'> <textarea class="tinymce" rows="2" name="item[requirements_attributes][new_requirements][requested_information]" id="item_requirements_attributes_new_requirements_requested_information"> </textarea> <script> tinyMCE.init({ selector: "textarea.tinymce", max_chars: 1000, // max. allowed chars setup: function (ed) { var allowedKeys = [8, 37, 38, 39, 40, 46]; // backspace, delete and cursor keys ed.on('keydown', function (e) { if (allowedKeys.indexOf(e.keyCode) != -1) return true; if (tinymce_getContentLength() + 1 > this.settings.max_chars) { e.preventDefault(); e.stopPropagation(); return false; } return true; }); ed.on('keyup', function (e) { tinymce_updateCharCounter(this, tinymce_getContentLength()); }); }, init_instance_callback: function () { // initialize counter div $('#' + this.id).prev().append('<div class="char_count" style="text-align:right"></div>'); tinymce_updateCharCounter(this, tinymce_getContentLength()); }, paste_preprocess: function (plugin, args) { var editor = tinymce.get(tinymce.activeEditor.id); var len = editor.contentDocument.body.innerHTML.length; var text = $(args.content).text(); if (len + text.length > editor.settings.max_chars) { alert('Supera el limite de' + editor.settings.max_chars + ' caracteres.'); args.content = ''; } else { tinymce_updateCharCounter(editor, len + text.length); } } }); function tinymce_updateCharCounter(el, len) { $('#' + el.id).prev().find('.char_count').text(len + '/' + el.settings.max_chars); } function tinymce_getContentLength() { return tinymce.get(tinymce.activeEditor.id).contentDocument.body.innerText.length; } </script> </div> </div> </div> <div class='remove-nested'> <input type="hidden" name="item[requirements_attributes][new_requirements][_destroy]" id="item_requirements_attributes_new_requirements__destroy" value="false" /><a class="remove_fields dynamic" href="#"><i class='material-icons'>remove_circle_outline</i> Remover </a></div> </div> " href="#"><i class="material-icons">add_circle_outline</i> Agregar </a></div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_delivery_way">Forma de entrega de la información</label></div> <div class="columns medium-18 small-23"><select name="item[delivery_way]" id="item_delivery_way"><option value="">Seleccione</option> <option value="cd">CD</option> <option value="dvd">DVD</option> <option value="usb">USB</option> <option value="photocopy">Fotocopia</option> <option value="certified_photocopy">Fotocopia certificada</option> <option value="email">Correo electrónico</option> <option value="fax">FAX</option> <option value="mail">Correo nacional</option> <option value="direct_consultation">Consulta directa</option></select></div> </div> </div> <br> <h2>Identidad</h2> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_document_type">Tipo de documento</label></div> <div class="columns medium-18 small-23"><select name="item[document_type]" id="item_document_type"><option value="">Seleccione</option> <option value="dui">DUI</option> <option value="passport">Pasaporte</option> <option value="resident_card">Carné de residente</option> <option value="student_card">Carné de estudiante</option> <option value="minority_card">Carné de minoridad</option> <option value="license_card">Licencia de conducir</option> <option value="lawyer_card">Carné de abogado</option> <option value="another_one">Otro documento de identidad</option></select></div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_document_number">No. de documento</label></div> <div class="columns medium-18 small-23"><input type="text" name="item[document_number]" id="item_document_number"/></div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_document_front_image">Adjunte documento de identidad</label></div> <div class="columns medium-18 small-23"> <input type="file" name="item[document_front_image]" id="item_document_front_image"/> <br> <i class="muted"> Incluya frente y dorso del documento de identidad </i> <br> <i class="muted"> 5MB , JPG / PNG / DOC / DOCX / PDF </i> </div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_document_back_image">Adjunte firma autógrafa</label></div> <div class="columns medium-18 small-23"> <input type="file" name="item[document_back_image]" id="item_document_back_image"/> <br> <i class="muted"> 5MB , JPG / PNG / DOC / DOCX / PDF </i> </div> </div> </div> <div class="control"> <div class="row align-middle align-justify"> <div class="columns medium-5 small-23"><label for="item_other_document">Adjunte documento adicional</label></div> <div class="columns medium-18 small-23"> <input type="file" name="item[other_document]" id="item_other_document"/> <br> <i class="muted"> 5MB , JPG / PNG / DOC / DOCX / PDF </i> </div> </div> </div> </div> <div class="control"> <div class="row align-center"> <div class="columns small-23"> <center> <script src="https://web.archive.org/web/20190705035922js_/https://www.recaptcha.net/recaptcha/api.js" async defer></script> <div data-sitekey="6LfmfhwTAAAAAAZRwse-x8hISJnaOPjGja3ijqEL" class="g-recaptcha "></div> <noscript> <div> <div style="width: 302px; height: 422px; position: relative;"> <div style="width: 302px; height: 422px; position: absolute;"> <iframe 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