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ADO Parte A: 1. Nombre del Reclamante 2. N mero de Seguro Social 3. Direcci n 4. Programa Indique el n mero de seguro social en la reclamaci n si es diferente al anterior. 5. Oficina Local 6. Solicito una reconsideraci n de la determinaci n emitida en por la siguiente raz n: No me aparecen salarios en el periodo b sico. No me aparecen todos los salarios devengados en el per odo b sico. Los salarios que aparecen son menores que los devengados. Otras razones (Explique): 7. Nombr.

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