Está en la página 1de 2
FORMATO NTEGRADO DE AFLIACIONY NOVEDADES Feaeedigwcuare {fiduprevisora) ( HOVEDAD A REPORTAR oer ws Opa) WO oe FESTACONES OCMES 08 HDSTERD fi nbecoee tere persone ahem ened To Water a caronp anaes ng) o fe sence coos et reenter S ates ce been Stren ninine o basen ce Potts SK taoontentearce Sa fe conan ceesaiotanoscatne BL etmea Preece 5 conse secndconee tans eters Swiss enone sain creme rn tees 5 fe. rotesson nena crac o i DATOS DEL COTEANTE PRNCIPAL frst yes — 7s = o = a 1 [nine de domme ed [p- usa veo tenes [Ecrec | forenno [I] vesoine [EI] erate [IF Oscameces | Fses [Co] weens [J fc. [Comrie Novas -Atooirtoes [CI] Rozaesy Paeraens Wai? [EI] Riosrdpme|(—]] Pitot oGino CI [tcc erosion Tesco [rewire | [eitecre —T Pewee (SO. Eero OT fu taseeo] [etonsasnen fo exescvt | case [i] ovacon [OI] retee FI] seo [uvone T vwo T TT TI p.Seouare tEanastr silent a= [zceonerccosines | [enneneronaee I we aa a a Bs m7 1 Parnes HE] AB | POT PRT MR FE ipa deeament ms [oc] co] cel cn pus [wl ea Tac psc[ a m es Be 85 “Tee Pes oe exci = ‘ran [Doaraconer Primera |. mur ydeparament ce eid Sequncoapatico | Prmer sombre 1 Deparment ce Spelion Bi fee | es] oe os [e ocepesses [or [oe [os Segundo rome E muncio de pede [¥-naTos UcACIONDE ATENGIONENEALUD (iigenc exe campo ou es cavas en gut odio deen asean ion mibmos ued luge donde [sea reir secin en ae Bevel | eve 5 \.DECLARACIONES YAUTOREACIONES Fe ec epic SS pm aa ag PT aN OO te rece eae $1 [OT] wo [TFs nares do atos ys do 2 aos pd sontnbarers a ome 81 I] wo |S fae ryoe tee peer cin ce east st [Ove [Pee 81 |) 0 [nye cnpatow pare 8 [©] |Chtcnnmenmcsaare anon quanmcanecgenveginoa! | Ele Sate ea oe ed aac >} im 0s «aad aconates de acuerdo con|a grein on a Lay 1561 402012 y of Decree 1377 0 2012 51 |] 8 | arrange Fgrdns Fonts Nesom do Prstasores Secs gio rue inbemace a coro onc ott xa mers ote SS ee lil we laces asec) no ase eas see i> [>] (8 y uso, reclame yi # raves emis #ecosics ifomatcos 0 eemsicos en as orbalas de rege yan eqs enades privadasy pubicas| Ege ne eee eee vas Firma cel Cotizarte. “ue ve ntocomsdatnte [me] vw mermuccones RC TNO DIGENAENTO FORMATO NTEGRGOE ARAGON HOVEDAES {anemia m my npt OAS prh,u gctn s t Se ipcnnne sootaeonspocmataee aa ta Ses | eS SSS Pe sw ngne as sen 7 fossa sanesestsceu 1 toe a ‘Fine ance sat come es Sora cee) jp = © |eredecin yeegacere en een] ‘rer face eats tpece Caen jst act at pn 0 se E Taee aa ame a [occa oe ee el Sarena oa Soe ~ freon oe coin oameabudewereine gis — OIE frm So ‘auaceanapt ae

También podría gustarte