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<title>Documento sin título</title>
<style type="text/css">
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		.datos{
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<body>

<table width="870" class="datos" >
<tr  >
  <th colspan="4" align="center"  ><strong>Pago por Autorizar</strong></td>
  </tr>
<tr>
<td width="65" >Motivo:</td>
<td width="299">&nbsp;</td>
<td width="134">Observaciones:</td>
<td width="352">&nbsp;</td>
</tr>
<tr>
  <td >Solicita:</td>
  <td>&nbsp;</td>
  <td>Fecha de solicitud:</td>
  <td>&nbsp;</td>
</tr>
<tr>
  <td >Monto:</td>
  <td>&nbsp;</td>
  <td>&nbsp;</td>
  <td>&nbsp;</td>
</tr>
<tr>
  <td >Persona o Institución</td>
  <td>&nbsp;</td>
  <td>No. de cuenta</td>
  <td>&nbsp;</td>
</tr>
<tr>
  <td >Banco</td>
  <td>&nbsp;</td>
  <td>Nombre de la cuenta</td>
  <td>&nbsp;</td>
</tr>
<tr>
  <td >CLABE</td>
  <td>&nbsp;</td>
  <td>&nbsp;</td>
  <td>&nbsp;</td>
</tr>
<tr>
 <th colspan="4">Propiedad Relacionada</th>
          </tr>
	      <tr>
	        <td>Propiedad</td>
	        <td>&nbsp;</td>
           <td>Departamento</td>
            <td></td>
		  </tr> 
 <tr> <th colspan="4">Ingrese los siguientes datos autorizar el pago </th>
          </tr>
	      <tr>
	        <td>Usuario</td>
	        <td><input type="text" name="usuario" id="usuario" onChange="javascript:this.value=this.value.toUpperCase();"></td>
           <td></td>
            <td></td>
          </tr>
	      <tr>
	        <td>Contraseña</td>
	        <td><input type="password" name="pass" id="pass" onChange="javascript:this.value=this.value.toUpperCase();"></td>
             <td></td>
            <td></td>
          </tr>
		  <tr>
	        <td>Mensaje para Contadora</td>
	        <td colspan="2"><textarea name="comentario" rows="4" cols="70"></textarea></td>
	        <td>Autorizar 
	          <input type="checkbox" name="Autorizar" id="Autorizar" />
            <label for="Autorizar"></label></td>
             
          </tr>

</table>

</body>
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