EN EFECTIVO
S/.
.......................................
EN BIENES
S/.
......................................
S/.
.......................................
TOTAL
----------------------------------------------------.......................................................................
DNI N .........................
........................................................................................................
........................................................................................................
........................................................................................................
........................................................................................................
TOTAL
S/. .........................
S/. .........................
S/. .........................
S/. .........................
S/. .......................
-------------------------------------------------............................................................
(NOMBRES Y APELLIDOS)
TITULAR GERENTE
DNI N