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__________ 20__

[ADDRESSEE]
[Designation/Position], [CORPORATE NAME]
[Address line 1]
[Address line 2]

ACKNOWLEDGMENT RECEIPT

Received from _________________________ the amount of ____________________


(Php _______________) in ________________________________________
representing the payment of ______________________________ mentioned in the
________________________________________ dated __________ 2019 between
____________________ (the “_______________”) and
____________________, represented by its _______________,
____________________ (the “_______________”), for the
__________________________.

-Nothing Follows-

Received by:

___________________________

[Designation in a contract, if any: Second Party, Borrower, etc.]

By:

___________________________

Authorized Signature

___________________________

Date and Time

Conforme:

___________________________

[Designation in a contract, if any: First Party, Lender, etc.]

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