ACKNOWLEDGEMENT RECEIPT

This is to acknowledge the receipt of ____________________________ (P

), to me in hand paid by Russell Reynald V. Gaerlan, Filipino, of legal age, single,
and a resident of Brgy. Ilocanos Sur, City of San Fernando, La Union representing
partial payment from the sale of real property (house and lot) from Mr. Bernard
Fernandez, situated at Brgy. Cabaroan, City of San Fernando, La Union, covered by
Certificate of Title No. 025-2021000219, consisting of 112 sq. m.

IN EVIDENCE WHEREOF, I have hereunto set my hand, this ___________ at

City of San Fernando, La Union, Philippines

____________________
Signature over Printed Name

Witness:

____________________
Signature over Printed Name

____________________
Signature over Printed Name

SUBSCRIBED AND SWORN TO before me this ____________________ at

_____________________.

Doc No. ______

Page No. _____

Book No. ______

Series of ______