Septemeber 18, 2013

ACKNOWLEDGEMENT RECEIPT

Received from (name of buyer) the amount
of (amount in words) in cash, of Philippine currency,
representing the payment of a vehicle of which, I, the
undersigned is the owner thereof:

MAKE : MOTOR NO. :
SERIES : SERIAL/CHASSIS NO. :
TYPE OF BODY : PLATE NO. :
YEAR MODEL : FILE NO. :
C.R. NO. :

Said cash payment is proof that I have sold the said
motor vehicle to (buyers name)





Received by:



Signature Over Printed Name

Received from:

Signature Over Printed Name

Witnesses:

1.

2.