FORMULARIO PARA

LA PRESENTACION
DE FACTURAS

Formulario 110 v.3

FORMULARIO ANEXO
Formulario Dependiente

Formulario 702 (STI)

Formulario 610 (RC - IVA)

Contribuyente Directo

Formulario 510 (Profesiones

Liberales u oficios)

NUMERO DE ORDEN

NIT

2881179B5BA1

PERIODO

NOMBRES Y APELLIDOS

EDITH LEON CABEZAS GARECA

DOMICILIO

BARRIO SAN JORGE II

TIPO DE DOCUMENTO DE IDENTIDAD CEDULA DE IDENTIDAD

NIT DEL EMPLEADOR

FOLIO

MES

AO

10

2016

NRO DE DOCUMENTO

1782697

LUGAR DE EXPEDICION

TARIJA

1024357022

NOMBRES Y APELLIDOS O RAZON SOCIAL DEL EMPLEADOR

DOMICILIO DEL EMPLEADOR

U.A.J.M.S.

AV. VICTOR PAZ ESTENSORO ESQ. COLON

DETALLE DE FACTURAS (En Bolivianos sin centavos)

NRO.

NUMERO DE
FACTURA

NIT

NUMERO DE
AUTORIZACION

FECHA
DIA/MES/AO

IMPORTE DE LA
COMPRA

CODIGO DE
CONTROL

1884360017

11103

275101600002196

15/06/2016

42

1024061022

88644

416401600057707

30/06/2016

163

5051833015

365

275101600070884

05/07/2016

245

1854380012

450

263101600014676

08/07/2016

66

1833909015

36695

112101600011892

08/07/2016

25

1799968018

18611

6004001583773

11/07/2016

22

777331018

217

463101600058606

12/07/2016

155

1884519013

1805

269101600064853

12/07/2016

20

FACTURA
ELECTRONICA

3E-C6-97-DF-3F

A9-15-95-E3

1602106017

33727

258405600004023

12/07/2016

21

8C-98-20-E8-D6

10

1015447026

68519

271401600060904

13/07/2016

51

03-81-B9-BB-18

11

1621566019

33046

258401600002523

14/07/2016

35

9E-1E-D3-21-47

12

1621566019

34480

258401600002523

18/07/2016

28

06-90-FF-16

13

1621566019

35142

258401600002523

20/07/2016

24

FA-FB-FC-7B-18

14

1024717022

200613

296401600002038

21/07/2016

378

09-6F-CA-C0

15

1602106017

45423

258405600004023

22/07/2016

28

9C-EB-44-2C-03

16

3450521012

532

463101600065087

22/07/2016

667

17

1602106017

48004

258405600004023

24/07/2016

21

18

5013227013

2620

269101600049784

25/07/2016

240

19

1621566019

37107

258401600002523

26/07/2016

21

0F-91-A4-BA

20

1621566019

37525

258401600002523

27/07/2016

21

28-C0-1E-F9-E2

21

5013227013

2668

269101600049784

28/07/2016

20

22

1621566019

37990

258401600002523

29/07/2016

35

64-C0-C4-7A-3D

23

1020295022

298

127401600009368

30/07/2016

54

D3-D1-C2-FE

24

1799968018

38761

269401600052766

30/07/2016

2D-2B-E1-67-5E

25

1024715025

84775

299401600004698

31/07/2016

97

AE-78-D8-18

26

1024061022

120426

416401600057707

31/07/2016

163

6A-16-4C-05-5B

27

1833909015

41600

112101600013304

01/08/2016

44

28

1621566019

39311

258401600002523

02/08/2016

105

29

5013554012

1057

173101600000268

02/08/2016

35

30

3093195014

5621

274101600109529

02/08/2016

56

31

5347086019

764

383101600067591

02/08/2016

70

32

227006025

205998

402401600001132

02/08/2016

300

AF-75-ED-26-D7

E4-0C-32-63-A7

02-2E-2F-7E-91

1/3

33

1015447026

20308

263401600005623

02/08/2016

120

34

1420703014

2813

274101600133081

03/08/2016

112

1D-6F-5F-6C-DE

35

1024543021

652

117401600000828

04/08/2016

27

AC-F5-8A-C8-E8

36

1799968018

32970

269401600053892

04/08/2016

21-5D-C3-FC

37

1799968018

32968

269401600053892

04/08/2016

33

26-49-F5-E3

38

20280018

2781

268101600068900

04/08/2016

42

39

5013227013

2752

269101600049784

04/08/2016

60

40

1024725024

687

255401600031144

04/08/2016

118

78-AC-89-73-CB

41

1015447026

21016

263401600005623

06/08/2016

75

34-6D-2A-A2-B3

42

1621566019

41803

258401600002523

10/08/2016

35

9D-3C-A7-D6-D0

43

1024357022

4076

445401600003106

11/08/2016

195

DB-F2-F9-ED

44

1621566019

43550

258401600002523

15/08/2016

35

AE-43-4E-90-6E

45

1621566019

44366

258401600002523

19/08/2016

35

AB-6B-2E-B5-AF

46

1015447026

2017

271401600134985

23/08/2016

19

5D-84-78-C7-9A

47

1621566019

45635

258401600002523

23/08/2016

35

86-9D-B2-59-F8

48

1020295022

1012

127401600009368

25/08/2016

14

9A-83-02-F5-85

49

1621566019

46237

258401600002523

25/08/2016

35

56-30-34-C6

50

1015447026

1212

263401600020635

26/08/2016

120

4B-1C-BF-C7-12

51

1015447026

4211

271401600134959

27/08/2016

23

41-C2-2F-C2-01

52

1011775023

58785

277405600027002

27/08/2016

28

F4-40-A9-9A-5E

53

1621566019

47310

258401600002523

28/08/2016

35

B6-B3-A2-B0

54

280912028

26864

269401600072329

28/08/2016

53

31-69-F4-89

55

280912028

36040

332401600005349

28/08/2016

80

E7-5B-F7-91

56

132201026

73460

252405600011240

31/08/2016

70

4A-35-8C-6A-6F

57

1024061022

152287

416401600057707

31/08/2016

163

D1-DC-47-28-27

58

1015447026

2264

263401600020635

02/09/2016

141

7D-1B-8A-9F-6A

59

1621566019

50567

258401600002523

06/09/2016

35

A9-53-F6-44-0A

60

1621566019

51485

258401600002523

09/09/2016

21

4A-AE-5F-CA-DB

61

1621566019

52244

258401600002523

10/09/2016

70

4E-76-8C-C7-8F

62

1621566019

502

453405600000725

12/09/2016

70

7D-FC-4B-48

63

1884360017

21669

275101600106695

19/09/2016

29

64

1614099014

4090

384101600052309

21/09/2016

54

65

1833909015

53095

112101600019507

21/09/2016

41

66

5013227013

3453

269101600078868

21/09/2016

30

67

1621566019

3755

453405600000725

22/09/2016

35

68

4138229014

358

463101600056842

23/09/2016

68

69

4145049014

895

271101600111863

24/09/2016

48

70

1621566019

4989

453405600000725

26/09/2016

35

03-49-0D-D0-FA

71

228810029

2630

271401600105618

27/09/2016

42

20-E0-76-BF

72

1621566019

6133

453405600000725

29/09/2016

35

38-54-2F-5A-8E

73

1621566019

7068

453405600000725

01/10/2016

14

FA-07-85-FD-35

74

5013227013

3672

269101600078868

04/10/2016

70

75

1621566019

8006

453405600000725

04/10/2016

105

4D-60-B3-F1-38

76

1015447026

7509

263401600020635

04/10/2016

177

14-5B-47-2B

77

3755990015

9830

262401600051157

05/10/2016

38

65-6C-C6-E8-FA

78

1020703023

16749

416401600103110

06/10/2016

10

21-51-2E-1A-DD

69-C9-F7-6C

CANTIDAD TOTAL FACTURAS ELECTRONICAS

DETERMINACION DEL PAGO A CUENTA

COD.

IMPORTE

TOTAL DETALLE DE FACTURAS

026

5,996

DETERMINACION DEL PAGO A CUENTA

693

779

2/3

JURO LA EXACTITUD DEL PRESENTE

FORMULARIO

LUGAR

ACLARACION DE FIRMA

SELLO Y FIRMA DEL EMPLEADOR

TARIJA
DIA

MES

AO

10

10

2016

EDITH LEON CABEZAS GARECA

FIRMA

CI 1782697 TARIJA

3/3