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Date: _______________________

ACKNOWLEDGMENT RECEIPT

The undersigned hereby acknowledges receipt of the sum of


_______________________________________________ PESOS (P ____________________),
Philippine Currency, paid by ______________________________________ which payment
constitutes full/partial payment of the below described obligation:

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

If this is in partial payment of said obligation, the remaining unpaid balance on


this date is: P _________________.

Signed this ______ day of ______________________, 20___, at Digos City, Davao


del Sur, Philippines.

Received by:

__________________________

Witnesses:

_______________________________ _______________________________

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