ACKOWLEDGEMENT RECEIPT

I, MARIVIC B. GURA, VIRGILIN ANOS AND ZENAIDA BAULA, of legal age,

Filipino citizen, all female, resident of Brgy. 11, Brgy 8 and Brgy. 1 Poblacion,
Llorente, Eastern Samar. and a member of MADINASIGON PANTAWID AGRIVET
TRADERS ASSOCIATION hereby acknowledge receipt the amount of
____________________________________ PESOS (₱_____________) from
SLPA DSWD representing the full payment for our reimbursement during withdrawal
and encashment of our association funds in our expenses for __________________.

ACKNOWLEDGE and RECEIPT this ___ day of _______________ 2024.

VIRGILIN S. ANOS | MARIVIC B. GURA | ZENAIDA N. BAULA

Signature over Printed Name

Witnesses:

RICKY G. ASADON IMELDA ASADON

Punong Barangay Barangay Kagawad