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  • Formulario Unico de Tramite D.S. 004 - 96 - ED: I.E. #3073 - EL DORADO

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    Formulario Unico de Tramite D.S. 004 - 96 - ED: I.E. #3073 - EL DORADO

    Uploaded by

    Angel Miguel Tirado roque

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    FORMULARIO UNICO DE TRAMITE

    D.S. 004 – 96 – ED

    …………………………………………………
    MINISTERIO DE EDUCACIÓN
    UNIDAD DE GESTION EDUCATIVA UGEL 04
    …………….………………………………….
    I.E. N° 3073 - EL DORADO 1. SUMILLA.
    ZAPALLAL-PUENTE PIEDRA

    …………………………………………………………………………………………………………………………………………………………………………………
    2. DEPENDENCIA O AUTORIDAD A QUIEN SE DIRIGE

    …………………………………………………………………………………………………………………………………………………………………………………
    3. DATOS DEL USUARIO (NOMBRES Y APELLIDOS)

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    4. APELLIDOS Y NOMBRES DEL ALUMNO

    ………………………………………………………………………………… …………………………………………………………………………………
    4.1 GRADO, SECCIÓN Y AÑO (ULTIMO) 4.2 IE DE PROCEDENCIA

    …………………………………… ………………………..…….……… ………………………………….………………………..


    5. DNI 6. N° TELEFONO 7. CORREO ELECTRONICO

    …………………………………………………………………………………………………………………………………………………………………………………
    8. DOMICILIO DEL USUARIO (Av. Jr. Calle, Psje, Urb, Dist, prov.)

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    9. FUNDAMENTACIIÓN DEL PEDIDO.

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    10. DOCUMENTOS QUE SE ADJUNTAN

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    ………………………………………………………………………………………………………………………………………………………………………………..

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    11. Lugar y fecha 12. Firma

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