ACKNOWLEDGEMENT RECEIPT

That I, DARWIN JADE R. CARPO, with address B4 L1 Camia St. cor Cadena de Amor, Pembo
Makati City received from ____________________ with address at ____________________________
the amount of FIFTY THOUSAND PESOS ONLY (P 50 000.00) as full payment for one motor vehicle with
the following specifications:

Make: Motor No.

C.R No. Serial/Chassis No.
Type of Body Plate No.
Year Model File No.