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S&eacute;rie .......... Inscri&ccedil;&atilde;o INSS. ..........Per&iacute;odo......./......./ .......... a ....../......../ ..........Rendimentos: Sal&aacute;rio Mensal R$ .......... F&eacute;rias R$ .......... 1/3 Sobre F&eacute;rias R$ .......... 13&ordm; Sal&aacute;rio R$ .......... Outros R$ ..........Total dos Rendimentos R$ ..........Dedu&ccedil;&otilde;es: Previd&ecirc;ncia Socia .....% R$ .......... Adiantamentos R$ .......... Vale-transporte .....% .......... R$ Adiantamento do 13&ordm; .......... R$ ..... Faltas R$ .......... Outros R$ ..........Total das dedu&ccedil;&otilde;es R$ .......... Total a Receber .......... R$ Recebi a import&acirc;ncia supra de R$ .......... ( &nbsp; ), bem como .......... ( &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;) &nbsp;vales-transportes para utiliza&ccedil;&atilde;o no m&ecirc;s de ........ de .........Data<ol class="c3 lst-kix_list_1-0 start" start="1"><li class="c5 c4 c7">Assinatura do Empregado</li></ol></body></html>

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