COLEGIO DE MDICOS VETERINARIOS

Trmite de Autorizacin de Regencia Autorizacin ! Regi"tro de# E"ta$#ecimiento

CMV %G &&'(&)
*La" So#icitude" con dato" incom+#eto" no "ern ,i"ta" en Se"in de -unta Directi,a. AC/ERDO -D N0 &12)''3 &4 APROBAR LOS REQUISITOS PARA EL TRMITE DE LAS SOLICITUDES DE LAS REGENCIAS MDICO VETERINARIAS DE LAS SIGUIENTES CATEGORAS:
I 5Sin Cam$io de Regente6 - Estar al da ! las "#$tas al %$% !t$ d la !tr &a d la s$l'"'t#d - Para '!'"'ar l tr(%'t d a)r$*a"'+! d las r & !"'as %,d'"$ - t r'!ar'as s d * r( "a!" lar l t$tal d s# "$st$. E! "as$ d /# d'"0a r & !"'a !$ s a a)r$*ada s d -$l- r( l 123 d l d'! r$4 /# da!d$ l 523 r sta!t )ara s#6ra&ar l$s &ast$s ad%'!'strat'-$s. - S$l'"'t#d d R & !"'a ll !a "$! s#s 0$7as 8-5-9-: ;"$%)l ta< II 5 Con Cam$io de Regente6 - Estar al da ! las "#$tas al %$% !t$ d la !tr &a d la s$l'"'t#d - Para '!'"'ar l tr(%'t d a)r$*a"'+! d las r & !"'as %,d'"$ - t r'!ar'as s d * r( "a!" lar l t$tal d s# "$st$. E! "as$ d /# d'"0a r & !"'a !$ s a a)r$*ada s d -$l- r( l 123 d l d'! r$4 /# da!d$ l 523 r sta!t )ara s#6ra&ar l$s &ast$s ad%'!'strat'-$s. - Carta d r !#!"'a $ d s)'d$ d l r & !t a!t r'$r - S$l'"'t#d d r & !"'a "$! s#s 0$7as 8-5-9-: ;"$%)l ta< III 5 So#icitud +or +rimera ,ez6 - Estar al da ! las "#$tas al %$% !t$ d la !tr &a d la s$l'"'t#d - Para '!'"'ar l tr(%'t d a)r$*a"'+! d las r & !"'as %,d'"$ - t r'!ar'as s d * r( "a!" lar l t$tal d s# "$st$. E! "as$ d /# d'"0a r & !"'a !$ s a a)r$*ada s d -$l- r( l 123 d l d'! r$4 /# da!d$ l 523 r sta!t )ara s#6ra&ar l$s &ast$s ad%'!'strat'-$s. - R "$% !da"'+! d la ='l'al /# "$rr s)$!da s' %)r > "#a!d$ st, a"t'-a > r #!',!d$s "$%$ %!'%$ "ada 1 das d#ra!t l$s % s s d %ar?$ > a*r'l d l a@$ ! "#rs$. - =$r%#lar'$ "$! t'%*r s > a#t !t'"ad$ )$r #! a*$&ad$ - P rs$! ra A#rd'"a $ D "lara"'+! A#rada d A*$&ad$ !$ % !$r a tr s % s s ; ! "as$ d ) rs$!as 7#rd'"as< - =$t$"$)'a d ",d#la 7#rd'"a $ ",d#la d 'd !t'dad ;s &B! s a l "as$< - S$l'"'t#d s d r & !"'a "$! s#s 0$7as 8-5-9-: ;"$%)l tas<

Ta$#a de Gru+o" ! Ti+o" Gr#)$ Gr#)$ 28. E"ta$#ecimiento" 7armac8utico" 29. %#anta" Indu"tria#izadora" T')$s T')$s 28. La*$rat$r'$ 28. L("t $s 25. Dr$&# ra 25. Pr$d#"t$s P s/# r$s 29. =ar%a"'a 29. Sa"r'6'"'$ > D s0# s 2:. O6'"'!a Tra%'tad$ra d R &'str$s 2:. A- s 2C. E%*#t'd$s 2D. E# -$s 2F. =(*r'"a d C$!" !trad$s >G$ )r % ?"las Gr#)$ 25. E"ta$#ecimiento" Veterinario" C#9nico" T')$s 28. E$s)'tal s 25. Cl!'"as 29. C$!s#lt$r'$ 2:. La*$rat$r'$s d D'a&!+st'"$ 2C. Mat r!'dad s 2D. Esta*l "'%' !t$ M'Ht$ ;V t r'!ar'a< Gr#)$ 2:. Lugare" de Rie"go E+idemio#gico T')$s 28. S#*astas 25. C$rr'das d T$r$s 29. = r'as > EH)$s'"'$! s 2:. T$) s 2C. I$$l+&'"$s 2D. I$$"r'ad r$s 2F. EH)$rtad$r s I%)$rtad$r s d a!'%al s $ %at r'al d $r'& ! a!'%al 21. V !tas d %as"$tas > a"#ar'$s 2J. Otr$s Pr$d#"t$s d $r'& ! a!'%al

Timbre Fiscal 50oo

COLEGIO DE MDICOS VETERINARIOS 7ormu#ario de So#icitud de Autorizacin de Regencia

CMV 7O &&:(&)
A/TORI;ACI<N DE REGENCIA
S @$r s -unta Directi,a C$l &'$ d M,d'"$s V t r'!ar'$s Est'%ad$s S @$r s: *La" So#icitude" con dato" incom+#eto" no "ern ,i"ta" en Se"in de -unta Directi,a.

K$4 Dr. ;a<: LLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLL4 M,d'"$ V t r'!ar'$4 N$%*r A) ll'd$ )at r!$ A) ll'd$ %at r!$ Car!, d l C$l &'$ d M,d'"$s V t r'!ar'$s !B% r$ LLLLLLL4 ",d#la d 'd !t'dad !B% r$ LLLLLLG LLLLLL GLLLLLL G M ) r%'t$ s$l'"'tar A#t$r'?a"'+! d R & !"'a d l sta*l "'%' !t$ d l GRUPOLLLLLLLLLL > TIPO: LLLLLLLLLL D !$%'!ad$ 4 ) rt ! "' !t aLLLLLLLLLLLL LLLLLLLLLLLLLLLL4

U*'"ad$ ! LLLLLLLLLLLLLLLLL4 LLLLLLLLLLLLLLL4 LLLLLLLLLLLLLL %(s Ha"ta% !t Pr$-'!"'a "a!t+! d'str't$

! l s'&#' !t d$%'"'l'$ 6's"al:

LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL L$s t l,6$!$s d l Esta*l "'%' !t$ s$!: LLLLLLLLLLLLLLLLL =aH: LLLLLLLLLLLLLLL A)artad$ P$stal: LLLLLLLLLLLLLLL C$rr $ l "tr+!'"$LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. DATOS DEL REGENTE:; s d s#%a '%)$rta!"'a ll !ar t$d$s l$s s)a"'$s "$rr "ta% !t <. D'r ""'+! d r s'd !"'a: LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. T l,6$!$ 0a*'ta"'+!:LLLLLLLLLLLLL C l#lar:LLLLLLLLLLLLLLL =aH:LLLLLLLLLLLL A)artad$ P$stal:LLLLLLLLLLLLLLLLL C$rr $ l "tr+!'"$LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL. Me do! +or enterado ! ace+to #a di"+o"icin =ue anu#a #a +re"ente "o#icitud> "i una ,ez a+ro$ada #a Autorizacin de Regencia no cum+#o con todo" #o" re=ui"ito" #ega#e"> t8cnico" ! admini"trati,o" /# % 6# r$! )r - !'d$s -- ! #! )la?$ d tr '!ta das !at#ral s. ='r%$ ! LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL da LLLLLLLLL % s LLLLLLLLLLLLLLLLLLLL a@$ 522LLLLLL C'#dad Dr. ;a<.LLLLLLLLLLLLLLLLLLLLL N$%*r AUTENTICA LLLLLLLLLLLLLLLLLLLL DISTRI?/CI<N %or 7a,or indicar +or cua# tran"+orte "e en,9a LLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLL A) ll'd$ )at r!$ A) ll'd$ %at r!$ LLLLLLLLLLLLLLLLLL ='r%a

ORIGINAL6 Co#egio de M8dico" Veterinario" CO%IA6 Contratante CO%IA6 M8dico Veterinario

@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ A nom$re de6 @@@@@@@@@@@@@@@@@@@@@@@@@(

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COLEGIO DE MDICOS VETERINARIOS 7ormu#ario de So#icitud de Autorizacin de Regencia

CMV 7O &&:(&)
DECLARACI<N -/RADA
*La" So#icitude" con dato" incom+#eto" no "ern ,i"ta" en Se"in de -unta Directi,a. S @$r s -unta Directi,a C$l &'$ d M,d'"$s V t r'!ar'$s PRESENTE Est'%ad$s S @$r s: K$4 Dr. ;a<: LLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLL4 d s H$ LLLLLLLLLLL4
N$%*r A) ll'd$ )at r!$ A) ll'd$ %at r!$

LLLLLLLLLLLLLLLLLLLLL4 M,d'"$ V t r'!ar'$4 "ar!, d l COLEGIO DE MDICOS VETERINARIOS !B% r$ LLLLLLLLL4

Estad$ "'-'l

C,d#la d 'd !t'dad !B% r$ LLLLLLG LLLLLLG LLLLLLG - "'!$ d 4 LLLLLLLLLLLLLL4LLLLLLLLLLLLLL4LLLLLLLLLLLLLLL )r$-'!"'a "a!t+! d'str't$ 4 DECLARO BAAO AURAMENTO4 !$ t ! r "$%)r$%'s$s la*$ral s ! l %'s%$ la)s$ /# % '%)'da! "#%)l'r "$! l$s E$rar'$s d ) r%a! !"'a > d's)$!'*'l'dad st')#lad$ ! l

Contrato de Trabajo )ara la R

& !"'a V t r'!ar'a d l

Esta*l "'%' !t$ d l GRUPO LLLLLLLL> d l TIPO: LLLLLLLL4 d !$%'!ad$ LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL > P rt ! "' !t a LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL > #*'"ad$ ! LLLLLLLLLLLLLLLLLLLLLL4 Pr$-'!"'a LLLLLLLLLLLLLLL4 LLLLLLLLLLLLLL4 %(s Ha"ta% !t
Ca!t+! d'str't$

! l s'&#' !t d$%'"'l'$ 6's"al: LLLLLLLLLLLLLLLLLLLLLLLLL

LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL ='r%$ ! LLLLLLLLLLLLLLLLLLLLLLLL da LLLLLLLLL % s LLLLLLLLLLLLLLLLLLLL a@$ 522LLLLLL

C'#dad

Dr. ;a<.LLLLLLLLLLLLLLLLLLLLL
N$%*r

LLLLLLLLLLLLLLLLL
A) ll'd$ )at r!$

LLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLL
A) ll'd$ %at r!$ ='r%a

AUTENTICA
DISTRI?/CI<N
ORIGINAL6 Co#egio de M8dico" Veterinario" CO%IA6 Contratante CO%IA6 M8dico Veterinario

Timbre Timbre Abogados Fiscal 50oo 50oo

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COLEGIO DE MDICOS VETERINARIOS 7ormu#ario de So#icitud de Autorizacin de Regencia CMV 7O &&:(&) CONTRATO DE TRA?A-O
La" So#icitude" con dato" incom+#eto" no "ern ,i"ta" en Se"in de -unta Directi,a

E!tr !$s$tr$s

LLLLLLLLLLLLLLLLLLLLLLL N$%*r

LLLLLLLLLLLLLLLLLLLLLLL A) ll'd$ )at r!$

LLLLLLLLLLLLLLLLLL4 A) ll'd$ %at r!$

LLLLLLLLLLLL4 !a"'$!al'dad

%a>$r4 d s H$ LLLLLLLLLLLLLL4 LLLLLLLLLLLLLLLLLLLL 4LLLLLLLLLLLLLLLLLLLLLL4- "'!$ d LLLLLLLLLLLLLLLLLLLLLL4 Estad$ "'-'l )r$6 s'+! # $6'"'$ )r$-'!"'a LLLLLLLLLLLLLLLLL4 LLLLLLLLLLLLLLLLLLLLL4 ",d#la d 'd !t'dad !B% r$ LLLLLLLLL G LLLLLLLLL G LLLLLLL 4 "$! )$d r s Ca!t+! d'str't$ s#6'"' !t s d la ) rs$!a 7#rd'"a d !$%'!ada LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL4 "$! ",d#la 7#rd'"a !B% r$ LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL >G$ ! %' "ar("t r ) rs$!al4 > ! ad la!t d !$%'!ad$ l CONTRATANTE4 > Dr. ;a<: LLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLL4 LLLLLLLLLLLLLLLLLLLLLL N$%*r A) ll'd$ )at r!$ A) ll'd$ %at r!$ !a"'$!al'dad %a>$r4 d s H$ LLLLLLLLLLLLLLLLL 4 LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL 4 M,d'"$ V t r'!ar'$4 "ar!, d l COLEGIO DE Estad$ "'-'l MDICOS VETERINARIOS !B% r$ LLLLLLLLLLL4 ",d#la d 'd !t'dad !B% r$ LLLLLLLLG LLLLLLLL G LLLLLLLL G - "'!$ d 4 LLLLLLLLLLLLLLLLLL4 LLLLLLLLLLLLLLLLLLL4 LLLLLLLLLLLLLLLLLL4 > ! ad la!t d !$%'!ad$ l MDICO VETERINARIO4 Pr$-'!"'a "a!t+! d'str't$ 0 %$s "$!- !'d$ " l *rar l s'&#' !t Contrato de Trabajo /# "$%$ %!'%$ $6r " r( las &ara!tas > d r "0$s d l C+d'&$ d Tra*a7$4 s#s l > s s#)l t$r'as $ "$! Has4 s &B! l$ sta*l " l art"#l$ 58 d l "'tad$ "+d'&$4 ad %(s r'&',!d$s )$r las s'&#' !t s "l(#s#las: %RIMERA6 El MDICO VETERINARIO la*$rar( ! "al'dad d R & !t V t r'!ar'$ ! l sta*l "'%' !t$ d l GRUPO:

LLLLLLLLLLLLLLL > TIPO: LLLLLLLLLLLLLLLLLL d !$%'!ad$ LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL a 6a-$r d l CONTRATANTE > #*'"ad$ ! LLLLLLLLLLLLLLLLLLLLLLLL4 LLLLLLLLLLLLLLLLLLLLLLLLL4 LLLLLLLLLLLLLLLLLLLLLLLLLL4 )r$-'!"'a "a!t+! d'str't$ > %(s Ha"ta% !t ! l s'&#' !t d$%'"'l'$ 6's"al: LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL
SEG/NDA6 El MDICO VETERINARIO as#%'r( la d'r ""'+! t,"!'"a > "' !t6'"a > s r( r s)$!sa*l s$l'dar'$ "$! l CONTRATANTE4 )$r las '!6ra""'$! s l &al s $ r &la% !tar'as /# r'& ! las %at r'as d Sal#d PB*l'"a $ Sal#d A!'%al4 /# s d r'- ! d la $) ra"'+! d l sta*l "'%' !t$4 > "#a!d$ "$rr s)$!da4 s r s)$!sa*l d "#a!t$ a6 "t la 'd !t'dad4 )#r ?a > *# ! stad$ d las %at r'as )r'%as > )r$d#"t$s /# s la*$r !4 %a!')#l !4 %a!t !&a! > s#%'!'str !. TERCERA6 El da l'*r s %a!al s r( l LLLLLLLLLLLLLLLLLLLLLL4 )#d' !d$ s r -ar'ad$ "$! la d *'da a!t'"')a"'+!4 )r -'$ a"# rd$ !tr las )art s.

Timbre Abogados 50oo

C/ARTA6 El MDICO VETERINARIO s a7#star( ! t$d$ a las d'r "tr'" s > r &la% !t$s ad%'!'strat'-$s d l sta*l "'%' !t$. A/INTA6 El CONTRATANTE a)$rtar( l$s '%)l % !t$s ! " sar'$s )ara l d sarr$ll$ d la la*$r )r$6 s'$!al )ara la "#al s "$!trata al MDICO VETERINARIO. SEBTA6 El CONTRATANTE a"$!d'"'$!ar( #! l#&ar )ara l MDICO VETERINARIO4 /# &#ard "$!"$rda!"'a "$! s# d'&!'dad Pr$6 s'$!al. STIMA6 El salar'$ s r( "$%) t !t . l LLLLLLLLLLLL 3 d l -'& !t )ara l$s )r$6 s'$!al s ! M d'"'!a V t r'!ar'a4 s &B! l$ sta*l ?"a la a#t$r'dad

OCTAVA6 LOS CORARIOS SERDN6 SEGEN AC/ERDO -D N0 F&2)':1 &F> DE MEDIO TIEM%O O TIEM%O COM%LETO TODOS LOS DIAS SIN EBCE%CI<N> EN 7ORMA %ROGRAMADA G R/TINARIA

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COLEGIO DE MDICOS VETERINARIOS 7ormu#ario de So#icitud de Autorizacin de Regencia CMV 7O &&:(&) CONTRATO DE TRA?A-O *CORARIOS.
*La" So#icitude" con dato" incom+#eto" no "ern ,i"ta" en Se"in de -unta Directi,a. CORARIO DEL ESTA?LECIMIENTO
FAVOR INDICAR HORAS D$%'!&$ MAMANA TARDE NOCEE L#! s Mart s DAS M',r"$l s A# - s V' r! s S(*ad$

EL EORARIO DE PERMANENCIA DEL REGENTE EN EL ESTABLECIMIENTO SER: ;Hora de ##egada ! Hora de "a#ida<
7AVOR INDICAR CORAS D$%'!&$ MAMANA TARDE NOCEE EL EORARIO DE DIS%ONI?ILIDAD DEL REGENTE SER: 7AVOR INDICAR CORAS D$%'!&$ L#! s Mart s MAMANA TARDE NOCEE L#! s Mart s DAS M',r"$l s A# - s V' r! s S(*ad$

DAS M',r"$l s A# - s V' r! s S(*ad$

A7#st(!d$s d'"0$s 0$rar'$s a las sal'das > -'s'tas /# )r$6 s'$!al d R & !t V t r'!ar'$.

l MDICO VETERINARIO d *a r al'?ar ! 6#!"'+! d la*$r s t)'"as d s# tra*a7$

NOVENA6 El )r s !t Contrato de Trabajo r'& a )art'r d l da ! /# la A#!ta D'r "t'-a d l COLEGIO DE MDICOS VETERINARIOS a)r# *

la s$l'"'t#d d A#t$r'?a"'+! d R & !"'a > conc#uir "egIn #o e"ta$#ecido en #o" art9cu#o" '3 ! '1 de# Cdigo de Tra$aJo(
='r%a%$s ! CONTRATANTE: LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLL N$%*r A) ll'd$ )at r!$ A) ll'd$ %at r!$ ='r%a REGENTE VETERINARIO: LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLL LLLLLLLLLLLLLLLLLLLLLLLLLLLL N$%*r A) ll'd$ )at r!$ A) ll'd$ %at r!$ ='r%a LLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLLL da LLLLLLLLLLLLLLL % s LLLLLLLLLLLLLLLLLLLLLLL a@$ 522LLLLLLLLL

AUTENTICA LLLLLLLLLLLLLLLLLLLLLLLLLLL DISTRIBUCINN

ORIGINAL6 Co#egio de M8dico" Veterinario" CO%IA6 Contratante CO%IA6 M8dico Veterinario

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