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Instruções

  1. Imprima em impressora jato de tinta (ink jet) ou laser, em qualidade normal ou alta. Não use modo econômico.

    Por favor, configure margens esquerda e direita para 17mm.

  2. Utilize folha A4 (210 x 297 mm) ou Carta (216 x 279 mm) e margens mínimas à esquerda e à direita do formulário.
  3. Corte na linha indicada. Não rasure, risque, fure ou dobre a região onde se encontra o código de barras

Corte na linha pontilhada


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Cedente Agência / Código do Cedente Espécie Quantidade Nosso número

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Número do documento Contrato CPF/CEI/CNPJ Vencimento Valor documento

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(-) Desconto / Abatimento (-) Outras deduções (+) Mora / Multa (+) Outros acréscimos (=) Valor cobrado
         
Sacado

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Autenticação mecânica

Corte na linha pontilhada


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Local de pagamento Vencimento
QUALQUER BANCO ATÉ O VENCIMENTO
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Cedente Agência/Código cedente

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Data do documento No. documento Espécie doc. Aceite Data process. Nosso número

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Uso do banco Carteira Espécie Quantidade x Valor (=) Valor documento
 
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Instruções (Texto de responsabilidade do cedente)


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(-) Desconto / Abatimento
 
(-) Outras deduções
 
(+) Mora / Multa
 
(+) Outros Acréscimos
 
(=) Valor cobrado
 
Sacado


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Sacador/Avalista
  Cód. baixa

Autenticação mecânica


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