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FICHA DE REEMBOLSO/ Final LINAME 2024
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NOMBRES  y APELLIDOS 
             ( Jugador(a )
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RUT (11.111.111-1) (Jugador(a)
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TELÉFONO CELULAR ( Jugador(a)
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CORREO ELECTRÓNICO
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NOMBRES  y APELLIDOS 
       ( APODERADO )
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RUT (11.111.111-1) (Apoderado(a)
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CORREO ELECTRÓNICO   (Apoderado(a)
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Datos bancarios  
NOMBRE Y APELLIDO
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RUT (11.111.111-1)
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Datos bancarios
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Nombre del Banco
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Nª DE CUENTA 
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Adjuntar respaldo de gasto
comprobante de pago
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Ticket de vuelo 
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