Debit Note Format
Preprinted Requirements - Filling Requirements
Company Name RUC
COMPUTERIZED SYSTEMS S.A. RUC 1790182345001
Trade name Denomination
COMPUSYSTEM DEBIT NOTE
Numbering
Address of the matrix and the issuing establishment No. 004 - 003-0000095
(when applicable)
MATRIX: Av. de la Prensa OE4-50 and Vaca de Castro Quito Authorization No.
BRANCH: Luis Plaza Danin 818 and M. Alcivar Guayaquil (granted by the SRI)
Authorization No.
1047844855
Buyer’s business name
Sr.(es): ______________________________ Fecha de Emisión: _________________________
RUC or ID if a sales note is modified Type and number of receipt
RUC or ID: ___________________________
that is modified
Certificate that modifies: Invoice No. 002-015-0000035
Description of the good or service Value of the modification
Reason for the Modification Value of the modification
VAT amount 12%
VAT 12%
Validity VAT amount 0%
Valid for issuance until 05/2007 VAT 0%
TOTAL VALUE Total value of the modification
Printing house data
Carlos Angel Bolívar Mora / Bolívar Printing Press
Recipients
RUC: 1710501420001 / Nº. Autorización 2540 Acquirer / Copy: issuer