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Apellido Paterno Apellido Materno Nombres DOMICILIO N Calle Comuna Tel fono Dpto. Loc. e-mail Nombre Representante Legal o Mandatario Rut Representante Legal o Mandatario - Rut N GIRO O ACTIVIDAD Giro o Actividad C digo Actividad ACREDITACI N Formularios B sicos F4415 Cumplimiento Tributario (F22 AT, F29 PT) F3239 F22 Doc. Importador, fabricante, etc. F29 INFORME RESOLUTOR N de Resoluci n Fecha Unidad - Aprobaci n / Rechazo - Observaciones Resolutor El cont.

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