In Settlement of the following BLACK ARROW SECURITY AGENCY, INC.

……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Invoice No. Amount Purok 4, Ampayon, Butuan City 8600

VAT Reg. TIN 406-956-966-00004
No. 3151
Total Sales (VAT Inclusive) ACKNOWLEDGMENT RECEIPT
Less: VAT
Total Date______________________________
Less: SC / PWD Discount RECEIVED from ______________________________________________________________
Total Due with TIN ______________ and address at ____________________-
______________________
Less: Withholding Tax
engaged in the business style of
Amount Due
__________________________________________________
the sum of _____________________________________________pesos (P______________)
VATable Sales as partial/full payment for _________________________________.
VAT-Exempt Sales
Zero Rated Sales
VAT Amount
Total Sales By: ______________________________________
Form of Payment Cashier/Authorized Representative

Cash Check
………….