Date: ________________

ACKNOWLEDGMENT RECEIPT

This is to acknowledge receiving from __________________________________ the amount

of (in words) ________________________________________________________________
(P_________________) as payment for
_______________________________________________________________.

Payment Details:
Cash Payment: ______________
Bank and Check Number: ______________________
Check Date: _____________________

Received by:

__________________________
Signature over Printed Name

Date: ________________

ACKNOWLEDGMENT RECEIPT

This is to acknowledge receiving from ___________________________________the

amount of (in words) _______________________________________________________
only (P ____________________) as payment for
_______________________________________________________________.

Payment Details:
Cash Payment: ______________
Bank and Check Number: ______________________
Check Date: _____________________

Received by:

__________________________
Signature over Printed Name