<p style="text-align: center; line-height: 1;"><span style="font-size: 10pt;"><strong>PROHIBIDA SU VENTA</strong>&nbsp;</span></p>
<p style="text-align: center; line-height: 1;"><span style="font-size: 10pt;"><strong>Direcci&oacute;n:</strong></span><br /><span style="font-size: 10pt;">Estadio Municipal de la Juventud de Chongoyape, CHONGOYAPE - LAMBAYEQUE</span><br /><span style="font-size: 10pt;">16/06/2024 a la 01:15pm</span></p>
<p style="line-height: 1; text-align: left;"><span style="font-size: 8pt;">DNI:&nbsp; &nbsp; &nbsp; &nbsp; _______________________</span></p>
<p style="line-height: 1; text-align: left;"><span style="font-size: 8pt;">Nombre: _______________________</span></p>
<p style="text-align: center; line-height: 1;"><span style="font-size: 8pt;"><strong>P&oacute;liza N&deg;: 2009844277</strong></span></p>