CB ANDREW ASIA, INC. ACKNOWLEDGEMENT RECEIPT Date: ___________ Received From : The amount of : CB ANDREW ASIA, INC.

(P As partial/full payment of Name of Establishment/ Store: ` SIGNATURE OVER PRINTED NAME )

CB ANDREW ASIA, INC. ACKNOWLEDGEMENT RECEIPT Date: ___________ Received From : The amount of : CB ANDREW ASIA, INC. (P As partial/full payment of Name of Establishment/ Store: )

SIGNATURE OVER PRINTED NAME

CB ANDREW ASIA, INC. ACKNOWLEDGEMENT RECEIPT Date: ___________ Received From : The amount of : CB ANDREW ASIA, INC. (P As partial/full payment of Name of Establishment/ Store: )

CB ANDREW ASIA, INC. ACKNOWLEDGEMENT RECEIPT Date: ___________ Received From : The amount of : CB ANDREW ASIA, INC. (P As partial/full payment of Name of Establishment/ Store: )

SIGNATURE OVER PRINTED NAME

SIGNATURE OVER PRINTED NAME

CB ANDREW ASIA, INC. ACKNOWLEDGEMENT RECEIPT Date: ___________ Received From : The amount of : CB ANDREW ASIA, INC. (P As partial/full payment of Name of Establishment/ Store: )

CB ANDREW ASIA, INC. ACKNOWLEDGEMENT RECEIPT Date: ___________ Received From : The amount of : CB ANDREW ASIA, INC. (P As partial/full payment of Name of Establishment/ Store: )

SIGNATURE OVER PRINTED NAME

SIGNATURE OVER PRINTED NAME

C.B. ANDREW ASIA, INC.

TIN: 006 910 349 - 000