Republic of the Philippines
Province of South Cotabato
Municipality of Tboli
OFFICE OF THE MUNICIPAL VICE MAYOR
ACKNOWLEDGEMENT RECEIPT
To whom it may concern:
I _________________ resident of Sitio _________ Barangay
_______________have received the amount of PHP._______for
hospital______________ assistance/donation from the Vice Mayor’s Office, Tboli
South Cotabato.
Done this _______day of _____________ year ____ at Vice Mayor’s Office
Tboli South Cotabato.
Received by:
_______________________
Authorized Representative
Conformed:
______________________
VICE MAYORS OFFICE