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Dados pessoais
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1. Nome completo
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Your answer
2. Data de nascimento
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MM
/
DD
/
YYYY
3. Estado civil
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Solteiro (a)
Casado (a)
Separado (a) / Divorciado (a)
Other:
4. Endereço residencial (rua, número, complemento)
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Bairro
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Cidade
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Vitória
Vila Velha
Serra
Cariacica
Other:
5. Telefone para contato (DDD)
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Your answer
6. Celular para contato (DDD)
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