SALARY SETTLEMENT

(According to Art. 236 of the C. of L..S. No. 000001

the T.)
MINISTRY OF JUSTICE
AND WORK D
SERIES

Employer: XXX COMPANY No. Employer:

Surnames and First Names of the Worker: SO-AND- CINo.
SO from
Payment Period: 01 to AUGUST 31 2011
Working Basic Sub Extra Other Total Discounts Balance to
Days salary Total hours I ate sions income Salary IPS Others Charge

31 1,828,055 1,828,055 0 0 0 1,828,055 149,241 641,896 1,036,918

8/31/2011
DATE EMPLOYEE'S
SIGNATURE