Acknowledgement Form

Your request(s) for copies of Birth / Marriage / Death Certificates /

CENOMAR (Singleness) have been confirmed.

Please print TWO (2) copies of this page.

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You will be asked for a copy of this page upon paying for your requests in
our designated banks.

A copy of this Acknowledgement Form has also been sent to you through
email.

LUCKY ANGELO C.
Requester's Name:
JUSAYAN
Delivery Address: 235 3B MANRIQUE
ST.
SAMPALOC,MANILA
MANILA, MANILA
PHILIPPINES 1008
Request Date: 1/4/2011
0402-1008-1100-
Batch Request Number:
0103
Total No. Of Copies Requested: 2
Total Amount Due: PHP 730.00

Request Request Copie Amoun

Request Details
Referenc Type s t
e
Number Name Date Place (in PHP)
 LUCKY
0402- PHILIPPINE
ANGELO
1008- 8/22/198 S ORIENTAL
CENOMAR CATAPAN 1 415.00
1100- 3 MINDORO
G
2131 GLORIA
JUSAYAN
COPY LUCKY
0402- PHILIPPINE
ISSUANCE - ANGELO
1008- 8/22/198 S ORIENTAL
BIRTH CATAPAN 1 315.00
1100- 3 MINDORO
CERTIFICAT G
1118 GLORIA
E JUSAYAN

Use the BATCH REQUEST NUMBER when you are paying for ALL the
requests that you have submitted online and when you are inquiring about
the processing status of ALL your requests in a batch using the Verify
Request Status facility in the e-Census website.

Use the REQUEST REFERENCE NUMBER when you are paying for
a SINGLE request and when you are inquiring about the processing status
of a SINGLE request using the Verify Request Status facility in the e-
Census website. Also use the Request Reference Number when inquiring
about the location of your requested document/s with our local courier.

You can pay at any Banco De Oro or UnionBank branch nationwide. Banco
De Oro account holders may pay via BDO Phone Banking, BDO ATM and
myBDO Internet Banking. UnionBank account holders may pay via
UnionBank Online Banking and UnionBank ATM (please refer to
the FAQs for additional information).

For more information, click on the links below:

View Bank Payment Procedures
View myBDO Internet Banking Payment Procedures
View UnionBank Online Banking Payment Procedures
Find out answers to other FAQs

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