REPUBLIC OF THE 

PHILIPPINES)

Quezon City) SS.

AFFIDAVIT OF ACCEPTANCE OF PAYMENT

I, AMERODING MENOR Y SANGCAD, of legal age and residing/with

address at B6 L50 Baseco Port Area Manila under oath, state:

1. THAT on August 21, 2022, I received an amount of 8,000 pesos

(eight thousand pesos) in cash from Reinelda L. Menes;

2.       THAT the amount given by Reinelda Menes is the money to be

used to repair my motorcycle due to the accident that happen last July
6, 2022;

3.       THAT I am executing this Affidavit to attest to the truth of the

foregoing facts and to use the same for whatever legal purpose it may
serve.

IN WITNESS WHEREOF, I hereunto affix my signature this _____________

of ______________ at __________________.

____________________________

Affiant

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

BEFORE ME, a Notary Public for and in Quezon City this ____________
day of ____________________, personally appeared
__________________________________ with ____________________________ ID No.
________________________________ known to me to be the same person who
executed the foregoing instrument and acknowledge the same to be their
free and voluntary act and deed.

SUBSCRIBED AND SWORN to before me this _______________ at

__________________, Affiant exhibiting to me his Community Tax Certificate
bearing No. ________________ issued at _________________ on
___________________________.

Doc No. ________;

Page No. _______ ;
Book No. _______;
Series of 2005.