CAPTURA SOLICITUD DE REEMBOLSO

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PARAMETROS CONSULTA

* IATA Agencia

* Nit Agencia

* Consecutivo

CAPTURA SOLICITUD REEMBOLSO

NUMERO DE SOLICITUD

* IATA Agencia

<body>

<table class=wc03A6178C cellpadding=0 cellspacing=0 x:str>
 <col class=wc03A61940 width="33" style='mso-width-source:userset'>
 <col class=wc03A63A00 width="71" style='mso-width-source:userset'>
 <col class=wc03A624C8 width="60" style='mso-width-source:userset'>
 <col class=wc03A624C8 width="111" style='mso-width-source:userset'>
 <col class=wc03A6178C width="47" style='mso-width-source:userset'>
 <col class=wc03A63A00 width="73" style='mso-width-source:userset'>
 <col class=wc03A624C8 width="60" style='mso-width-source:userset'>
 <col class=wc03A624C8 width="102" style='mso-width-source:userset'>
 <col class=wc03A6178C width="32" style='mso-width-source:userset'>
 <col class=wc03A6178C width="0" style='display:none;mso-width-source:userset'>
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 <col class=wc03A6178C width="0" style='display:none;mso-width-source:userset'>
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 <col class=wc03A6178C width="0" style='display:none;mso-width-source:userset'>
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 <col class=wc03A6178C width="0" style='display:none;mso-width-source:userset'>
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 <tr height="34" style='mso-height-source:userset;mso-height-alt:510'>
  <td class=wc03A61940> </td>
  <td class=wc0158162C
  x:str="Este formato esta concebido para facilitar el calculo del reembolso, pero la correcta aplicacisn de las tarifas es plena resposabilidad del agente."
  colspan="7">Este formato esta concebido para facilitar el calculo del
  reembolso, pero la correcta aplicacisn de las tarifas es plena resposabilidad
  del agente.</td>
  <td> </td>
  <td> </td>
  <td> </td>
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  <td> </td>
 </tr>
 <tr height="36" style='mso-height-alt:540'>
  <td class=wc03A61940> </td>
  <td class=wc01B46BF4 x:str="Tarifa original" colspan="3">Tarifa original</td>
  <td class=wc01B46F64> </td>
  <td class=wc01B4879C x:str="Tarifa Usada" colspan="3">Tarifa Usada</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
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  <td> </td>
 </tr>
 <tr height="26" style='mso-height-source:userset;mso-height-alt:390'>
  <td class=wc03A61940> </td>
  <td class=wc0100C1EC x:str="TRAYECTOS">TRAYECTOS</td>
  <td class=wc0100C3D0> </td>
  <td class=wc0100C3D0 x:str="MONTO">MONTO</td>
  <td class=wc0100C5A4> </td>
  <td class=wc0100C778 x:str="TRAYECTOS ">TRAYECTOS </td>
  <td class=wc0100C96C> </td>
  <td class=wc0100C96C x:str="MONTO">MONTO</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
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  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01003884> </td>
  <td class=wc01002EB8> </td>
  <td class=wc0100256C x:fmla="=UPPER(B4)" x:str=""></td>
  <td class=wc01000224 x:fmla="=UPPER(C4)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D4" x:num=""></td>
  <td> </td>
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 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B5)" x:str=""></td>
  <td class=wc01000224 x:fmla="=UPPER(C5)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D5" x:num=""></td>
  <td> </td>
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 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B6)" x:str=""></td>
  <td class=wc01000224 x:fmla="=UPPER(C6)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D6" x:num=""></td>
  <td> </td>
  <td> </td>
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  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B7)" x:str=""></td>
  <td class=wc01000224 x:fmla="=UPPER(C7)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D7" x:num=""></td>
  <td> </td>
  <td> </td>
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  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B8)" x:str=""></td>
  <td class=wc01000224 x:fmla="=UPPER(C8)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D8" x:num=""></td>
  <td> </td>
  <td> </td>
  <td> </td>
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  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B9)" x:str=""></td>
  <td class=wc01000224 x:fmla="=UPPER(C9)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D9" x:num=""></td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
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  <td> </td>
  <td> </td>
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  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B10)" x:str=""></td>
  <td class=wc01000224 x:fmla="=UPPER(C10)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D10" x:num=""></td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:str="SI">SI</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
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  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B11)" x:str=""></td>
  <td class=wc01000224 x:fmla="=UPPER(C11)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D11" x:num=""></td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:str="NO">NO</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc01008A2C x:num="00.08">8%</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
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  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B12)" x:str=""></td>
  <td class=wc01008CC8 x:fmla="=UPPER(C12)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D12" x:num=""></td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc01008A2C x:num="00.16">16%</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B13)" x:str=""></td>
  <td class=wc01008CC8 x:fmla="=UPPER(C13)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D13" x:num=""></td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc01008A2C x:num="0">0%</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B14)" x:str=""></td>
  <td class=wc01008CC8 x:fmla="=UPPER(C14)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D14" x:num=""></td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc01008A2C> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010062A0> </td>
  <td class=wc010058E8> </td>
  <td class=wc01007434> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01007608 x:fmla="=UPPER(B15)" x:str=""></td>
  <td class=wc01008CC8 x:fmla="=UPPER(C15)" x:str=""></td>
  <td class=wc010071E8 x:fmla="=D15" x:num=""></td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B4A94C> </td>
  <td class=wc01B4AB20> </td>
  <td class=wc01B4AD04> </td>
  <td class=wc01002EB8> </td>
  <td class=wc01B4AED8 x:fmla="=UPPER(B16)" x:str=""></td>
  <td class=wc01B4B164 x:fmla="=UPPER(C16)" x:str=""></td>
  <td class=wc01B4B3E4 x:fmla="=D16" x:num=""></td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc0100CB80 x:str="'//">//</td>
  <td class=wc0100CB80 x:str="'//">//</td>
  <td class=wc0100CCF8 x:str="'//">//</td>
  <td class=wc01B46F64> </td>
  <td class=wc0100CB80 x:str="'//">//</td>
  <td class=wc0100CB80 x:str="'//">//</td>
  <td class=wc0100CECC x:str="'//">//</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01009054 x:str="NUC">NUC</td>
  <td class=wc01009248> </td>
  <td class=wc0100942C x:fmla="=SUM(D4:D16)" x:num=""></td>
  <td class=wc01B46F64> </td>
  <td class=wc01009054 x:str="NUC">NUC</td>
  <td class=wc01009248> </td>
  <td class=wc0100942C x:fmla="=SUM(H4:H16)" x:num=""></td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010097A4 x:str="ROE">ROE</td>
  <td class=wc010078DC> </td>
  <td class=wc01007ABC x:num="1">1.00000000</td>
  <td class=wc01B46F64> </td>
  <td class=wc010097A4 x:str="ROE">ROE</td>
  <td class=wc010078DC> </td>
  <td class=wc01007CD0 x:fmla="=D19" x:num="1">1.00000000</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc0100CCF8> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc0100CECC> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01009054 x:str="Fare">Fare</td>
  <td class=wc01008108 x:str="USD">USD</td>
  <td class=wc010082FC x:fmla="=ROUND(D18*D19,0)" x:num="0">0</td>
  <td class=wc01B46F64> </td>
  <td class=wc01009054 x:str="Fare">Fare</td>
  <td class=wc01582338 x:fmla="=C21" x:str="USD">USD</td>
  <td class=wc010082FC x:fmla="=ROUND(H18*H19,0)" x:num="0">0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010097A4 x:str="Tasa USD/">Tasa USD/</td>
  <td class=wc01588840 x:fmla="=C21" x:str="USD">USD</td>
  <td class=wc0158E4F0 x:num="1">1.000000</td>
  <td class=wc01B46F64> </td>
  <td class=wc010097A4 x:str="Rate USD/">Rate USD/</td>
  <td class=wc01588840 x:fmla="=G21" x:str="USD">USD</td>
  <td class=wc0158E4F0 x:fmla="=D22" x:num="1">1.000000</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc015834E4 x:str="Equivalente">Equivalente</td>
  <td class=wc01588840 x:str="USD">USD</td>
  <td class=wc015836D8 x:fmla="=ROUND(D21*D22,0)" x:num="0">USD 0</td>
  <td class=wc01B46F64> </td>
  <td class=wc015834E4 x:str="Equivalente">Equivalente</td>
  <td class=wc01588840 x:str="USD">USD</td>
  <td class=wc01583A14 x:fmla="=ROUND(H21*H22,0)" x:num="0">USD 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010097A4 x:str="Tasa COP/">Tasa COP/</td>
  <td class=wc01583CD0 x:str="USD">USD</td>
  <td class=wc01583ECC x:num="2410">COP 2,410.00</td>
  <td class=wc01B46F64> </td>
  <td class=wc010097A4 x:str="Rate COP/">Rate COP/</td>
  <td class=wc01583CD0 x:str="USD">USD</td>
  <td class=wc0158B110 x:fmla="=D24" x:num="2410">COP 2,410.00</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010097A4 x:str="Equivalente">Equivalente</td>
  <td class=wc01583CD0 x:str="COP">COP</td>
  <td class=wc01273B08 x:fmla="=ROUND(D23*D24,-2)" x:num="0">COP 0</td>
  <td class=wc01B46F64> </td>
  <td class=wc010097A4 x:str="Equivalente">Equivalente</td>
  <td class=wc01583CD0 x:str="COP">COP</td>
  <td class=wc01273B08 x:fmla="=ROUND(H23*H24,-2)" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010097A4 x:str="YS (IVA)">YS (IVA)</td>
  <td class=wc01273EB8 x:num="00.08">8%</td>
  <td class=wc01273B08 x:fmla="=ROUND(D25*C26,)" x:num="0">COP 0</td>
  <td class=wc01B46F64> </td>
  <td class=wc010097A4 x:str="YS (IVA)">YS (IVA)</td>
  <td class=wc01007ATG x:fmla="=C26" x:num="00.08">8%</td>
  <td class=wc01273B08 x:fmla="=H25*G26" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01274568> </td>
  <td class=wc01274758> </td>
  <td class=wc01274944 x:num="0">COP 0</td>
  <td class=wc01B46F64> </td>  
  <td class=wc03A670CC x:fmla="=IF($H$18=0,0,B27)" x:num="0">0</td>
  <td class=wc01274758> </td>
  <td class=wc03A673EC x:fmla="=IF($H$18=0,0,D27)" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=ROUND(AT28/D24,2)" x:num="29.79">29.79</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01274568></td>
  <td class=wc01274758> </td>
  <td class=wc01274944 x:num="0">COP 0</td>
  <td class=wc01B46F64> </td>
  <td class=wc03A670CC x:fmla="=IF($H$18=0,0,B28)" x:num="0">0</td>
  <td class=wc01274758> </td>
  <td class=wc03A673EC x:fmla="=IF($H$18=0,0,D28)" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td class=wc03A676A4> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=SUM(D27:D32)" x:num="0">COP 0</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01274568> </td>
  <td class=wc01274758> </td>
  <td class=wc01274944 x:num="0">COP 0</td>  
  <td class=wc01B46F64> </td>
  <td class=wc03A670CC x:fmla="=IF($H$18=0,0,B29)" x:num="0">0</td>
  <td class=wc01274758> </td>
  <td class=wc03A673EC x:fmla="=IF($H$18=0,0,D29)" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01274568> </td>
  <td class=wc01274758> </td>
  <td class=wc03A69CE8 x:num="0">COP 0</td>
  <td class=wc01B46F64> </td>
  <td class=wc03A670CC x:fmla="=IF($H$18=0,0,B30)" x:num="0">0</td>
  <td class=wc01274758> </td>
  <td class=wc03A673EC x:fmla="=IF($H$18=0,0,D30)" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01274568> </td>
  <td class=wc01274758> </td>
  <td class=wc03A69CE8 x:num="0">COP 0</td>
  <td class=wc01B46F64> </td>
  <td class=wc03A670CC x:fmla="=IF($H$18=0,0,B31)" x:num="0">0</td>
  <td class=wc01274758> </td>
  <td class=wc03A673EC x:fmla="=IF($H$18=0,0,D31)" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=SUM(H27:H32)" x:num="0">COP 0</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01274568> </td>
  <td class=wc01274758> </td>
  <td class=wc03A69CE8 x:num="0">COP 0</td>
  <td class=wc01B46F64> </td>
  <td class=wc03A670CC x:fmla="=IF($H$18=0,0,B32)" x:num="0">0</td>
  <td class=wc01274758> </td>
  <td class=wc03A673EC x:fmla="=IF($H$18=0,0,D32)" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=(H40+H44)/D24" x:num="50">USD 50</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc010097A4 x:str="Total">Total</td>
  <td class=wc010078DC> </td>
  <td class=wc01273B08 x:fmla="=SUM(D25:D32)" x:num="0">COP 0</td>
  <td class=wc01B46F64> </td>
  <td class=wc010097A4 x:str="Total">Total</td>
  <td class=wc010078DC> </td>
  <td class=wc01273B08 x:fmla="=SUM(H25:H32)" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=H45/D24" x:num="0">USD 0</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6C2CC> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6C2CC> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=H47-H46" x:num="0">USD 0</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6C2CC> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6C2CC> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=ROUND(AT31/D24,2)" x:num="0">USD 0</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0 x:str="Valor a reembolsar (tarifa + impuestos)">Valor a
  reembolsar (tarifa + impuestos)</td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6C4C4 x:fmla="=D33-H33" x:num="0">COP 0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=ROUND(H33/D24,2)" x:num="0">USD 0</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc0100CB80> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc0100CB80> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=ROUND(H36/D24,2)" x:num="0">USD 0</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc0127858C x:str="DEDUCCIONES" rowspan="8" style='border-bottom:
  solid .5pt black'>DEDUCCIONES</td>
  <td class=wc03A6D2A0 x:str="Penalidad por reembolso (desistimiento)">Penalidad
  por reembolso (desistimiento)</td>
  <td class=wc03A6D2A0> </td>
  <td class=wc03A6D2A0> </td>
  <td class=wc03A6D2A0> </td>
  <td class=wc03A6D488 x:fmla="=C21" x:str="USD">USD</td>
  <td class=wc01007434 x:num="0">0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td class=wc03A67890 x:fmla="=ROUND(H36/D24,2)" x:num="0">USD 0</td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0 x:str="Penalidad por No show/otros">Penalidad por No
  show/otros</td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc03A6DD24 x:fmla="=C22" x:str="USD">USD</td>
  <td class=wc01007434 x:num="0">0</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0 x:str="Equivalente COP penalidades">Equivalente COP
  penalidades</td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6E038 x:fmla="=(H38+H39)*D24" x:num="0">COP 0</td>
  <td> </td>
  <td class=wc03A67890 x:str="ADP">ADP</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0 x:str="Net Remit / descuentos / Incentivos">Net Remit /
  descuentos / Incentivos</td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc03A6E374 x:str="LOCAL">LOCAL</td>
  <td class=wc01007434 x:num="0">COP 0</td>
  <td> </td>
  <td class=wc03A67890 x:str="LOCAL">LOCAL</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc01274758> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0 x:str="Cargo procesamiento administrativo reembolso">Cargo
  procesamiento administrativo reembolso</td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6E5C4 x:num="50">USD 50.00</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0 x:str="Equivalente COP cargo administrativo">Equivalente
  COP cargo administrativo</td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6E038 x:fmla="=H43*D24" x:num="120500">COP 120,500</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc03A6E980 x:str="IVA cargo administrativo">IVA cargo
  administrativo</td>
  <td class=wc03A6E980> </td>
  <td class=wc03A6EB6C> </td>
  <td class=wc03A6E980> </td>
  <td class=wc03A6ED44 x:num="00.16">16%</td>
  <td class=wc03A6E038 x:fmla="=H44*G45" x:num="19280">COP 19,280</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc0100CB80> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc03A6EF98> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc03A6F15C x:str="Neto a reembolsar">Neto a reembolsar</td>
  <td class=wc03A6F15C> </td>
  <td class=wc03A6F35C> </td>
  <td class=wc03A6F52C> </td>
  <td class=wc03A6F15C> </td>
  <td class=wc03A6F35C> </td>
  <td class=wc03A6F718 x:fmla="=H36-H40-H41-H44-H45" x:num="-67980">-COP 67,980</td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
 <tr height="17" style='mso-height-alt:255'>
  <td class=wc03A61940> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc0100CB80> </td>
  <td class=wc01B46F64> </td>
  <td class=wc01B45DE0> </td>
  <td class=wc0100CB80> </td>
  <td class=wc0100CB80> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
  <td> </td>
 </tr>
</table>

</body>

</html>

* Nit Agencia

* Nombre de la Agencia

* E-Mail de la Agencia

* Ciudad Agencia

* Régimen IVA

* Agencia es Gran contribuyente?

* Régimen de retenciones (Auto retenedor?)

* % Comisión

* INFORMACION PAGADOR / PASAJERO

* Nombre Pagador Original

* Nit Pagador Original

* Nombre pasajero

* Numero Tiquete Original

* Fecha de Expedición Tiquete Original (dd/mm/aaaa)

* Numero Tiquete a reembolsar

* Fecha de expedición tiquete a Reembolsar (dd/mm/aaaa)

* Forma de Pago

Clase de tarjeta de crédito

Numero de tarjeta de Crédito

Número de Autorización

Forma de Pago 2

Clase de tarjeta de crédito 2

Numero de tarjeta de Crédito 2

Número de Autorización

Forma de Pago 3

Clase de tarjeta de crédito 3

Numero de tarjeta de Crédito 3

Número de Autorización

* Causal del reembolso

* Estado

INSTRUCCIONES
1.	Imprima esta Solicitud
2.	Fírmela y Sellela
3.	Adjunte los Tiquetes a Reembolsar
4.	Envie todo a Navesoft Calle 100 No. 8A - 49 Piso 8, Bogotá
5.	Por correo electrónico le avisaremos el estado del proceso de reembolso, el cual ud. puede tambien consultar aquí