ACKNOWLEDGMENT RECEIPT

I, _______________________________________, of legal age, married,

Filipino and a resident of _____________________________ hereby acknowledge
receipt of sum money from ______________________ of legal age, Filipino,
married and resident of _________________________________________________
in the amount of _______________________________________PESOS
(Php_____________) as ______________________________________________.

Done this ______ day of ____________ at Iloilo City, Philippines.

______________________________
(Signature over printed name)