ACKNOWLEDGEMENT RECEIPT

That I, AUREA BELEN P. BALIAT, with address at 126 Avocado St. Tanza Tuguegrao City
received from LAILA R. PAREDES with address at 75 Maharlika Highway, Caggay Tuguegrao
City the amount of ONE HUNDRED THOUSAND PESOS ONLY (P 100,000.00) as full deposit for
one motor vehicle with the following specifications:

MAKE : MOTOR NO. :

C.R. NO. : SERIAL/CHASSIS NO. :

TYPE OF BODY : PLATE NO. :

YEAR MODEL : FILE NO. :

Received in good condition, “ as is where is”.

Conforme:

AUREA BELEN P. BALIAT LAILA R. PAREDES

SELLER’S PRINTED NAME and SIGNATURE BUYER’S PRINTED NAME AND SIGNATURE

Acknowledgement of Documents:

Original:

Photocopy of Vendor’s Valid I.D.

Deed of Conditional Sale