CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc
---oOo---

GIY XC NHN
H v tn (ghi ch in hoa): .........................................................................................................................
a ch

: ................................................................................................................................

Hin ang lm vic ti (ghi tn y ca cng ty)

......................................................................................................................................................................
a ch cng ty

: ................................................................................................................................

in thoi

: ................................................................................................................................

B phn

: .................................................. Chc v: ............................................................

Mc lng chnh

: ................................. VN/ thng

Ph cp

: ................................. VN/ thng

Trn y l tng thu nhp bnh qun trn thng ca 6 thng gn y nht.
.........., ngy .......... thng ......... nm 2011 .....
Xc nhn ca cng ty

K v ghi r h tn

(K, ghi r h tn, chc v v ng du)

Tt c l nh my v khi in th xa dng ny!

QF 02/UIL 05.07

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