Republic of the Philippines

DEPARTMENT OF TRANSPORTATION
LAND TRANSPORTATION OFFICE
Zone 1-B Brgy. Tulat, San Jose City, Nueva Ecija

Field Office: SAN JOSE CITY DISTRICT OFFICE TIN: 001704153000

Office Code: 0384 Date: 07/19/2023 2:55 PM

OFFICIAL RECEIPT 0384-000000061163

RECEIVED FROM (Last Name, First Name Middle Name)
DE LEON JR, LAZARO FERNANDEZ
ADDRESS (No. Street, Barangay, Municipality, Zip Code, Province)
Minanglo, San Francisco, San Antonio, 3108, Nueva Ecija
TIN (Tax Identification Number) LTO Client ID / LTO BUSINESS ID
23-821029-7141095

PAYMENT DETAILS BREAKDOWN OF PAYMENT

Transaction No: MAIRD-SAR-20230710- Cost of plate PHP 120.00
339456
MVUC PHP 720.00
Plate No: 843WJE Science Tax PHP 40.50
File No: 038423000136453
Classification: Private - (PVT) Transfer Fee PHP 50.00

Vehicle Type: Motorcycle Without Sidecar Legal Research Fee PHP 10.00
Fuel Type: Gas
Aircon Type: N/A
Color: WHITE
Year Model: 2023
This payment is valid until
03/2027 and due for
renewal on 03/08/2027-
03/14/2027.

TOTAL AMOUNT PAID: PHP 940.50

AMOUNT IN WORDS: NINE HUNDRED FORTY PESOS AND 50/100
CENTAVO(S)

MODE OF PAYMENT: SM Bills

LOCATION: -

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

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