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Republic of the Philippines

Department of Finance
BUREAU OF INTERNAL REVENUE
Revenue Distrcit Office No. 067 Manito
Manito, Albay

ANNEX A

Inclusive Serial Numbers


Accountable Form Name Quantity (Pads)
Beginning Ending

Revenue Official Receipt ROR2014-02477752 ROR2014-02477800 1

Prepared by:

CARMELA M. MAYOR
Revenue Officer II

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