ACKNOWLEDGMENT RECEIPT

Date:___________________

I/We, ___________________________________________, both of legal age, Filipino/s,

single/married, and with residence and postal address at ________________________________,
do hereby acknowledge the receipt of the amount _______________________________ PESOS
(P _______________.00), Philippine Currency from ______________________________, both
of legal age, Filipino/s, single/married, and with residence and postal address at
________________________________, as payment full payment for a certain parcel of land
with/without improvement located in _______________________________________________,
containing an area of ________________________________________ and covered by Transfer
Certificate of Title No. ________________________.

Received by:

____________________________________ ____________________________________
Seller Seller
_______ID No.____________ _______ID No.____________
Tin No. __________________ Tin No. __________________

Conforme:

____________________________________ ____________________________________
Buyer Buyer
_______ID No.____________ _______ID No.____________
Tin No. __________________ Tin No. __________________

Signed in the presence of:

__________________________________ __________________________________

SUBSCRIBED AND SWORN TO BEFORE ME this ____________at ____________.

Parties exhibited to me their Competent Evidence of Identity abovementioned.