Formulario Envio Especimenes

  • October 2019
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ENVIO DE ESPECIMENES Departamento de Entomología MUSEO DE HISTORIA NATURAL UNIVERSIDAD NACIONAL MAYOR DE SAN MARCOS Apartado Postal 14-0434, Lima-14, PERU Tlf: (+51-1)471-0117

Nº Fecha Date

El material mencionado abajo contenido en ha sido enviado como: The material listed below, contained in has been sent as: donación (gift) intercambio (exchange) préstamo (loan) por (for) para identificación a nuestro pedido (for identification) devolución (return) A (To):

meses (months) ..............

Preparado por Prepared by Autorizado por Authorized by

Devolver una copia firmada a la dirección arriba Return a signed copy to address above

Recibido en buenas condiciones Recived in good condition .............................

Todo holotipo y el 50% de los paratipos basados sobre material nuestro deberá ser devuelo a nuestras colecciones (All holotypes and 50% of paratypes based on our collections shall be returned to us.)

Firma (Signature): ………...………….........…. Fecha (Date): ………………..……......……….

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