ACKNOWLEDGEMENT RECEIPT

Received from __________________________ accused in criminal case number

________ now pending under MeTC Branch 35 of Quezon City, The amount of
______________________ (PHP________ ). This 6th day of January 2021, as partial
payment for the total obligation that the accused has to pay.

Quezon City, Metro Manila

Received payment by: ___________________

Private Complainant

Payable by: ___________________

Accused

Witnessed by:___________________