MINDANAO ENERGY SYSTEMS, INC.

Tablon, Cagayan de Oro City

ACKNOWLEDGEMENT RECEIPT OF DOCUMENTS

January 11, 2016

This is to acknowledge the receipt of the following documents from

MINDANAO ENERGY SYSTEMS, INC, (MINERGY) upon my separation
from the company as Casual / Probationary / Regular Employee
effective __________. I hereby release the company free from further
issuance of the same and other documents in the future.
Signature Date
1. BIR Form 2316
________
_________
2. Sick Leave/ Vacation Leave Conversion
________
_________
3. Quitclaim / Request for Clearance
________
_________
4. Certificate of Employment
________
_________
5. Final Pay
________
_________

Signed in the Presence of

_______________________ and ________________________

__________________________
(Signature over Printed Name)
__________________________
(Designation)