Region VI-Regional Trial Court JEP-23-000336848

MAMBUSAO, Capiz

Date and Time Paid: Aug 25, 2023 10:19 AM Transaction No.: wdkltVB1C5t7
Date and Time Posted: Aug 25, 2023 10:19 AM Confirmation No.: 2753336716780
Mode of Payment: Online Payment - UPay Assessment No.: RTC534824571
Name of Payor: NENET G ESPOSO Reference No.: 88c5aeee4e8948d8a238e249193a284a
Nature of Collection: File Case, Supplemental Payment Status: PAID
Pleadings, and Answers
Case Type: Other Special Proceedings Not Concerning Property
Case No./Roll/MCLE/Bar N/A
Examinee No.
Case Title/Particulars: PETITION FOR CANCELLATION OF CERTIFICATE OF LIVE BIRTH OF MA. RHEA PALACIOS
GANZON. NENET GANZON ESPOSO vs. MA. RHEA PALACIOS GANSON, ET. AL.

Assessment details:

Type of Fund/Nature of Payment Filing Fee Miscellaneous Fee Total Amount

JDF 168.00 112.00 280.00
SAJF 332.00 288.00 620.00
LRF 10.00
VCF 5.00
MF 500.00
STF 1,000.00
TOTAL AMOUNT: ₱ 2,415.00

Payment details:

OR No. Date and Time Amount Paid Running Balance

JEP-23-000336848 Aug 25, 2023 10:19 AM ₱ 2,415.00 ₱ 0.00
LATEST AMOUNT PAID IN WORDS: TWO THOUSAND FOUR HUNDRED FIFTEEN AND 00/100**

******** NOTHING FOLLOWS ********

NOTE 1: This serves as the Legal Fees Form. Convenience fee or bank charges are not part of the collection of the court.

Payment Confirmed & Verified by:

MARICAR F. FABELLA
Clerk of Court VI

SCP-JEP Version 4.0 Page 1 of 1 Printed on 08/25/2023 - 10:21 AM