Acknowledgement Receipt

This is to acknowledge the receipt of ______________________________________________ (PHP ___________)

(Amount in words) (Amount in figures)

from Mr./Ms. ____________________________________ as payment for _________________________________

(Payor) (Purpose)

given on ___________________________________ at _______________________________________________.

(Date) (Place)

Amount Received by:

________________________________________
Signature over Printed Name / Date

Acknowledgement Receipt

This is to acknowledge the receipt of ______________________________________________ (PHP ___________)

(Amount in words) (Amount in figures)

from Mr./Ms. ____________________________________ as payment for _________________________________

(Payor) (Purpose)

given this ___________________________________ at _______________________________________________.

(Date) (Place)

Amount Received by:

________________________________________
Signature over Printed Name / Date