ANNUAL MEMBERSHIP DUES MONITOR

CARD EXPIRY REFERENCE NO.

BILLED TO CUNANAN, RAYMOND CALIXTO
( Name /Company /Address Contact Info ) 202 DONA RITA ST.
/ 09757023303
MEMBER INFO PRC NUMBER PRC CARD EXPIRY SPECIALIZATION
UAP NUMBER 54222 DATE REGISTERED CHAPTER SUMMER CAPITAL
This represents your Annual Dues Monitor as per our Membership Database
P A R T I C U L A R S/ D E S C R I P T I O N AMOUNT

Fiscal Year IAPOA Number Official OR Date Annual Dues Penalty Total Total Remark Type of
Receipt Surcharges Amount Due Amount Paid Payments
NEW BOARD PASSER FEE 0 390874 062023 390874 06/20/2023 700.00 0.00 700.00 700.00
2023-2024 IAPOA 01/01/1000 600.00 60.00 660.00

SUMMARY OF PAYABLES AND PAYMENTS

Total Annual Dues Total Penalty Total Amount Due Total Amount Paid Balance
1,300.00 60.00 1,360.00 700.00 660.00
Remarks

Total Annual Paid Amount in Cash Check Amount & Details Bank to Bank Remarks
700.00 0.00 0.00

PREPARED BY CHECKED/ VERIFIED BY RECOMMENDING APPROVAL APPROVED BY

Evelyn P. Franco Alma Hilaria D. Valencia Rene Richie A. Corcuera, FUAP

Membership Officer Finance Officer National Officer
NOTE: This is a statement of your account as it appears on our books. Please examine this statement immediately.
If no discrepancy is reported within 2 days from the receipt of this statement, the account will be considered as correct.
our thanks, if payments have been already made. For more queries on your account, kindly call us at 8888 9266
( UAP Finance )
UAP NAO Form: Updated 09.06.10