<\/p>

<\/ul><\/div>\n
\n
\n<\/fieldset>\n
Descripci\u00f3n de los hechos (c\u00f3mo, cu\u00e1ndo y d\u00f3nde):
\n<\/span>\n<\/p>\n
D\u00eda que ocurrieron los hechos:
\n<\/span>\n<\/p>\n
En caso de existir testigos, menci\u00f3nelos:
\n<\/span>\n<\/p>\n
En caso de existir evidencia, descr\u00edbala:
\n<\/span>\n<\/p>\n
Informaci\u00f3n de contacto para estar en comunicaci\u00f3n, proporcione la que considere pertinente:
\n<\/span>\n<\/p>\n
\n<\/p>
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