ACKNOWLEDGMENT RECEIPT

PhP_______

I, CHLOE __________, of legal age, single, Filipino with residence at

________________ DO HEREBY ACKNOWLEDGE RECEIPT OF THE SUM
OF ONE HUNDRED THOUSAND PESOS (PhP100,000.00), from JAN
ERWIN A. ACOP as payment for ___________________, dated ___________.

This ______________ 2020, in the City of Baguio, Philippines.

CHLOE _______
Recipient

Conforme:

JAN ERWIN ACOP

Signed in the presence of:

1)_________________________ 2)_________________________

SUBSCRIBED and SWORN to before me this ______th day of _______

2021, in Baguio City, Philippines. Affiants exhibiting to me their government
issued identification cards, the details of which are indicated below their names.
The affiants avowed to the truthfulness of the foregoing statements.

Doc. No. ;
Page No. ;
Book No. ;
Series of 2021.