ACKNOWLEDGMENT RECEIPT

KNOW ALL MEN BY THESE PRESENTS:

This Acknowledgment Receipt is made by

__________________________, of legal age, married, Filipino and with
address at ______________________________________, hereinafter
referred to as “_______________”, to whom
_____________________________, of legal age, married, Filipino and with
address at __________________________________, have already paid the
amount of _________________________________ by way of full payment
in consideration
____________________________________________________.

_______________________, Digos City, Davao del Sur.

________________________________

CONFORME:

________________________________

ACKNOWLEDGMENT

BEFORE ME, the undersigned notary public for and in the said
place, appeared ______________________________ in person, identified
to me by virtue of current Identification Card No. __________ issued by
__________, to be the same person who signed the foregoing
instrument. He/she represented to me that the signature on the foregoing
instrument has been voluntarily affixed by him/her for the purposes stated
therein. He/she declared that he/she executed the foregoing instrument of
his/her own free and voluntary act and deed and that he/she is authorized to
sign the same. This acknowledgment refers to an Acknowledgment Receipt
consisting of one (1) page.

WITNESS MY HAND AND SEAL this ___________day of

______________ 2021 at _______________________, Philippines.

NOTARY PUBLIC

Doc. No.____;
Page No.____;
Book No.____;
Series of 2021.