Republic of the Philippines

DEPARTMENT OF TRANSPORTATION
LAND TRANSPORTATION OFFICE
DOMESTIC ROAD PASAY CITY

Field Office: PASAY CITY LICENSING CENTER TIN: 000865491001

Office Code: 1388 Date: 08/17/2023 11:24 AM

OFFICIAL RECEIPT 1388-000000253466

RECEIVED FROM (Last Name, First Name Middle Name)
VELOSO, PATRICK JAN ITALIO
ADDRESS (No. Street, Barangay, Municipality, Zip Code, Province)
157 Mayon, Post Proper Southside, Makati City, 1200, Metro
Manila, Fourth District
TIN (Tax Identification Number) LTO Client ID / LTO BUSINESS ID
000-632-063-886 23-010808-8543028

PAYMENT DETAILS BREAKDOWN OF PAYMENT

Transaction: TX-DLS-20230817-951387 - Application Fee PHP 100.00
01
Application: CHANGE OF DL
CLASSIFICATION, NP TO P
Classification: Driver's License
Lic. No: N03-21-006154

TOTAL AMOUNT PAID: PHP 100.00

AMOUNT IN WORDS: ONE HUNDRED PESOS

MODE OF PAYMENT: Cash

LOCATION: Pasay City Licensing Center (Southern)
CASHIER: Dolores DC. Axalan
POS MACHINE: PASAY CITY LC/RS_Cashier_1

This is a system generated Official Receipt. No Signatures needed.

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