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OF"FICIAL RECEIPT
Republic of the Philippires

Accountable Form No. 5I


Revised. August 1994
Quezon City
OFFICE OF THE TRE,I.SURER

ORIGINAT
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DATE
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PAYOR

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AND
NATURE oF CoLLECTIoN AMOUNT

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A:\jIOUNT IN
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tr C*h Received the Amount Strt"a \


Received n
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Treasury Warrant Above.
Check
tr Mqne-y Ordcr

Treasury Wanant, Check, Money


Order Number

Date ofTreasury Warrant, Check,


Mcney Order EDGAR T. vu,,olu"u^
CI.rY TREAsuitEE/
CoLLECTTNG orffcen
NOTE: lvrite the aunber and date of tbis receipt en the back of
treasury siarraftt, eheck or money otdet received.

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