ACKNOWLEDGMENT RECEIPT

Php__________,000.00

RECEIVED from __________________, of legal age, married, Filipinos

and a resident of _____________________, Ormoc City, Leyte, Philippines, the
sum of _____________________________ (Php_________________,000.00)
PESOS, Philippine Currency, representing partial/down payment of a portion of
___________________ (___________________) SQUARE METERS of that
certain parcel of land, re:

“A parcel of land (Lot ___________ of the subdivision plan Psd-

_______________, being a portion of Lot 1612 of the Cadastral Survey of
Ormoc, L.R.C. Cad. Record No. 1455), situated in
____________________, City of Ormoc, Province of Leyte. Bounded on
xxx xxx xxx; containing an area of _________________________
(________________) SQUARE METERS more or less covered by TCT
No. ______________________ of the Registry of Deeds for the Ormoc City
and Tax Declaration _______________________ of the Assessor’s Office
of Ormoc City.”

Ormoc City, Philippines, ________________________.

_________________________
Seller
CEI No. ________________________

SIGNED IN THE PRESENCE OF:

___________________________ _____________________________