ACKNOWLEDGMENT RECEIPT
TO WHOM IT MAY CONCERN:
That I, ___________________________________, of legal age,
Filipino citizen, with residence at ________________________________________, hereby
acknowledge the amount of ______________________________________
(Php___________________) Philippine Currency, from
__________________________________, of legal age, Filipino citizen with
residence at ______________________________________, as payment of
______________________________________________________________________.
IN WITNESS HERETO, we hereunto set our hands this at Bangued, Abra,
Philippines.
______________________ ______________________
SIGNED IN THE PRESENCE OF:
__________________ ____________________
SUBSCRIBED AND SWORN TO BEFORE ME this
___________________________ at Bangued, Abra, Philippines.
Doc. No. _____
Page No. _____
Book No. ____
Series of 2023