iINPEC ae eee
ESTABLECIMIENTO. NCIARIO DE ALTA Y MEDIANA SEG LA DORADA-CALDAS
FORMATO: ENTREGA DE DOTACION - SABANA Y SOBRESABANA
APELLIDOS Y NOMBRES ZULUAGA YEPES GUSTAVO ADOLFO
NU749688 7D 6177 PABELLON 3 FECHA: 05 DE12 DE 2019
cc 1053808683 Expedida en: Manizales-Caldas
‘Se Te hace entrega de 01 JUEGO DE SABANAS (Sabana y Sobre sabana) completamente
nueva, por el cual debe responder por su buen uso y estado de conservacion.
YO, el Interno X. 5e—— = _1D 6177 NU 749688
PABELLON RECEPCION me comprometo a darle buen uso a este elemento recibido, y
responder disciplinariamente por el deterioro ocasionado por el uso indebido que haga con
este elemento. (Art. 121 ley 65/93).
Observaciones: ENTREGA DE DOTACION — SABANA Y SOBRESABANA at incite:
PELALEPAMSLOO
Funcionario que entrega A\ JAMES MONSALVE N.
Interno que ee DE ce
1a
HUELLA INPEC
ESTABLECIMENTO PENITENGIARIO DE: FALTAY MEDIANA SEGURIDAD LA DORADA CAL
\CloN SABANAS Y SOBRESANA.
FORWATO ENTREGA DE ELEMENTO DE Dor
\4L PP. DEL EPAMS.DoRADA,
Gielos Exuaeso
=
pro SEZ EO, es.
fe le Hace entrega de 01 JUEGO DE SABANAS (Sébana y Sobre sdbana) completamente
‘nueva, por el cual debe responder por su buen use y octet de conservacién.
%0, of inom X LAYOs LALO Rampey, .» Sess __
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