ANNUAL MEMBERSHIP DUES MONITOR

CARD EXPIRY REFERENCE NO.

BILLED TO CABIGAS, HENRY PASCUAL
( Name /Company /Address Contact Info ) MAMBACAG TUAO CAGAYAN
/ 09156083767
MEMBER INFO PRC NUMBER 55873 PRC CARD EXPIRY SPECIALIZATION
UAP NUMBER 52671 DATE REGISTERED July 03, 2023 CHAPTER CAGAYAN VALLEY
This represents your Annual Dues Monitor as per our Membership Database
P A R T I C U L A R S/ D E S C R I P T I O N AMOUNT

Fiscal Year IAPOA Number Official OR Date Annual Dues Penalty Total Total Remark Type of
Receipt Surcharges Amount Due Amount Paid Payments
2022-2023 IAPOA 52671 378396 032723 378396 03/27/2023 700.00 0.00 700.00 700.00
2023-2024 IAPOA 52671 412016 093023 412016 09/30/2023 600.00 0.00 600.00 600.00

SUMMARY OF PAYABLES AND PAYMENTS

Total Annual Dues Total Penalty Total Amount Due Total Amount Paid Balance
1,300.00 0.00 1,300.00 1,300.00 0.00
Remarks

Total Annual Paid Amount in Cash Check Amount & Details Bank to Bank Remarks
1,300.00 0.00 0.00

PREPARED BY CHECKED/ VERIFIED BY RECOMMENDING APPROVAL APPROVED BY

Evelyn P. Franco Alma Hilaria D. Valencia Rene Richie A. Corcuera, FUAP

Membership Officer Finance Officer National Officer
NOTE: This is a statement of your account as it appears on our books. Please examine this statement immediately.
If no discrepancy is reported within 2 days from the receipt of this statement, the account will be considered as correct.
our thanks, if payments have been already made. For more queries on your account, kindly call us at 8888 9266
( UAP Finance )
UAP NAO Form: Updated 09.06.10