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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'DATOS DEL TITULAR' section. Enter your last name, first name, and identification numbers such as DNI, CI, LC, CUIT, and CUIL.
Next, complete the 'DATOS DEL APODERADO/GESTOR OFICIOSO' section if applicable. Provide the same details for the representative including their last name, first name, and identification numbers.
In the 'DOMICILIO DEL TITULAR/APODERADO QUE PRESENTA EL RECLAMO' section, input your address details including street name, number, postal code, locality, phone number, fax (if any), floor number, department (Dpto), province, and email.
Select the type of presentation under 'TIPO DE PRESENTACIÓN'. Indicate whether you are presenting personally or on behalf of beneficiaries. If representing others, fill in their names and document types.
Detail your claim in the 'DATOS DEL RECLAMO' section. Summarize your complaint and list any attached documentation.
Finally, review all information for accuracy before signing. Ensure you authorize any necessary actions as indicated at the bottom of the form.
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