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ACKNOWLEDGMENT RECEIPT

January 4, 2023

Received from Mr./Mrs. _________________________________, with address at


____________________________________________________________________________
The amount of ________________________________________________________________
(₱ ____________________) as Deposit/Earnest/Full Payment for one unit ________________
More particularly described as follow.

Make: Mitsubishi L300 Versan Van Chassis No.: PAEL65NV14B000794


Model No. : 2005 Engine No. : 4D56 – AP4969
Color: Silver Plate No. : VCD – 911

“RECEIVED UNIT IN GOOD RUNNING CONDITION SOLD ON AS IS WHERE IS BASIS.”

Conforme:

_____________________________
(Buyer’s Printed Name & Signature)
_____________________________
Tel. No.

Received By:

JOHN BRYNER G. JIMENEZ, RN


09275316363

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