Relief Acknowledgement Form

CONTACT NO.__________COV No. _________ PAGE ______of ________

No Name of Recipients Quantity Item Signature
.
1 PABLO B. LUNA
2 CENON VALLESTEROS
3 VLADIMIR FREIRES
4 RICARDO BENCITO
5 ALDRIN ALCOVENDAS
6 DANILO OLIVARES
7 JESHUAH DANIEL OLIVARES
8 CHRIZILO BASILGO
9 RAMIL GONZALES
10 ERLINDA BRIONES
11 MELODY AMBROCIO
12 GERALD AMBROCIO
13 REYNALDO BILUGAN
14 FREDIE HITOSIS
15 MARIVIC PANUELOS
16 ARNOLD ENCALLADO
17 MARK ANTHONY CATIGON
18 ALWIN BAY
19 TONY UBOGEN
20 ROMEL PADAON
21 GERALDO BARRIENTOS
22 JOSE PAULO BACENA
23 TOMAS BACENA
24 ROBERT CABILES
25 ALEXANDER JR. TIGNO
26 CHRIS MIGUEL BABIANO
27 JONATHAN ROYO
28 NOEL TABABA
29 GIOVANNI LEE
30 EDITHA ANAGO
31 CHRISTOPHER ANAGO
32 TERESITA ANACAY
33 GLENMAR BARLONGAY
34 GALMARX IGNACIO BARLONGAY
35 PAULINO BALDOMERO JR.

ITEM CODE I hereby certify that the above names of recipients, quantity forms and
Signature enumerated above are true and correct.

A.____________________ CERTIFIED BY: ________________________________ DATE: ________

B; _____________________ PRINTED NAME AND SIGNATURE
C._____________________ DESIGNATION: __________________________ ( in charge of distribution
D.______________________
OFFICE: __________________________________