Work & income

Supplementary Termination Amount Statement and Receipt

Supplementary statement of earnings, deductions, and net termination payment, with reservations and references to official records.

Updated on

What this document is for

Detail a supplementary termination payment without replacing the TRCT, eSocial records, or FGTS payments.

Information to prepare

The fields below come from the template itself and help you check the information before filling it in.

Document details

  • Razão social
  • CNPJ
  • Name full
  • CPF
  • CTPS número
  • CTPS serie

Additional information

  • Amount saldo salario
  • Amount ferias vencidas
  • Amount ferias proporcionais
  • Amount terco ferias
  • Amount 13 proporcional
  • Amount aviso previo

Additional information

  • Amount descontos
  • Amount total liquido
  • Regime indenização FGTS
  • Amount multa FGTS

Place, date and signatures

  • Signing city
  • Receipt date

How to complete and review it

  1. Confirm the document's purpose and the requirements of the person or organization that will receive it.
  2. Gather the supporting records and copy names, numbers, dates, and amounts exactly as they appear in the real sources.
  3. Complete the applicable fields, review the full preview, and correct inconsistencies before exporting.
  4. Review signatures, attachments, witnesses, deadlines, and formalities required for the specific case.

Limits and precautions

  • The template organizes the information provided, but it does not prove identity, authenticity, or the truth of the facts.
  • It does not replace an official record, professional advice, or legal, accounting, medical, or administrative review.
  • Acceptance, signatures, witnesses, notarization, registration, and attachments depend on the purpose, recipient, and current rules.

Legal reference stated in the template

The Brazilian reference recorded in the catalog is reproduced below in Portuguese. It is not a legal conclusion and does not replace checking the current rule. Use this statement as a starting point and check the current wording and the requirements of the specific case.

CLT e modelos oficiais de TRCT, TQRCT e THRCT aprovados pelo Ministério do Trabalho

Where to check official information

The portals below provide broad access to public services and rules. They do not, by themselves, confirm that this template fits your case.

Questions about this template

What is Supplementary Termination Amount Statement and Receipt used for?

Detail a supplementary termination payment without replacing the TRCT, eSocial records, or FGTS payments.

What information should I prepare before filling it in?

Start with Razão social, CNPJ, Name full, CPF, CTPS número, CTPS serie. Check each item against real records before completing the document.

Does this template replace professional advice or an official record?

It does not replace an official record, professional advice, or legal, accounting, medical, or administrative review.

Do I need notarization, registration, or witnesses?

Acceptance, signatures, witnesses, notarization, registration, and attachments depend on the purpose, recipient, and current rules.

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