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D. OTHER RECEIPTS
During the period JANUARY to JUNE 2012, did you or any member of your family receive in cash or in kind, other
receipts such as sale of real property; sale of personal property such as (clothing, jewelry, etc.); loans from other
families, business firms and government institutions for current consumption and investment; payment received for
loans granted to others (excluding interest); withdrawals from savings/business equity; net winnings from
gambling, profits from sale of stocks, back pay and proceeds from insurance, inheritance or other receipts?

1 – YES 2 - NO, GO TO PAGE 62 (E)

Item Code In Cash In Kind

1. Sale of real property 940010 ____________ ____________

2. Sale of personal property 940020 ____________ ____________

3. Loans from other families 940030 ____________ ____________

4. Loans from business firms (including sari-sari

stores and government institutions 940040 ____________ ____________

5. Payments received for loans granted to others 940050 ____________ ____________

6. Withdrawals from savings/business equity 940060 ____________ ____________

7. Net winnings from gambling, sweepstakes and 930080 ____________ ____________

Raffle

8. Profits from sale of stocks, bonds and

real and personal property 930090 ____________ ____________

9. Back pay and proceeds from insurance 930100 ____________ ____________

10. Inheritance 930110 ____________ ____________

11. Other receipts (tax refund, dowries, prizes 940070 ____________ ____________
received from tournaments, etc.)

TOTAL 940000 =========== ===========

COMPUTATIONS/REMARKS: