Sindicato dos Trabalhadores em Empresas Ferroviárias de São Paulo
Praça Alfredo Issa, n° 48    Centro       19° e 20° andares   CEP: 01033-906- São Paulo - S.P.
Fones: Secretaria 3228-7344 - Interno 3226-4294 - Juridico 3315-0563 Depto Assist. ao Ferroviário 3313-7076

Carne No |__|__|__|__|__|          Prontuário No |__|__|__|__|__|           Matr. Sindicato No |__|__|__|__|__|
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                   PROPOSTA DE ADMISSÃO - PENSIONISTA

 

 

Nome Pensionista (por extenso)                                                                                                                                                                         

Data de Nascimento   ______/_______/_______  Sexo (  )M   (  )F      Natural de ___________________________  UF_____

CIC                                                     Identidade                                            Nº do Benefício do INSS                                                          

Nome do Falecido (por extenso)_________________________________________________________ Carnê                         

Data do Falecimento  ______/_______/_______ Matrícula Empresa                                                 RFFSA    CPTM   MRS 

Residência                                                                                                                                                                             No                            

Bairro ______________________________ Cidade ___________________                UF ________ CEP _______________

Telefone (DDD, Número e Ramal)                                                                                                       Possui Paridade? Sim        Não   

 

DEPENDENTES

Nome                                                                                                                   Data Nascimento                 Parentesco

 

_________________________________________________             _____/__________/________    __________________

_________________________________________________             _____/__________/________    __________________

_________________________________________________             _____/__________/________    __________________

_________________________________________________             _____/__________/________    __________________

_________________________________________________             _____/__________/________    __________________

_________________________________________________             _____/__________/________    __________________

_________________________________________________             _____/__________/________    __________________

 

 

 

______________________________, ________ de _______________________ de ________

 

 

 

                                                                                                                                                                                                                                  

                               Assinatura do Proposto                                                                                   Assinatura do Proponente

                                                                                                                                                                            Sindicato

 

                                                                                                                                                                                                                                  

                               Assinatura do Secretário                                                                                 Assinatura do Presidente

                                               Sindicato                                                                                                             Sindicato

 

 

 

 

 

Observações: