ACKNOWLEDGEMENT RECEIPT

Received from Mr./Ms./Mrs. ______________________________________________ with address at

_____________________________________________________ the amount of
_________________________________________________________ PESOS (PHP _____________)
as Deposit/Earnest/Full Payment for one unit more particularly described as follows:

MAKE : ______________________________ CHASSIS NO.: ______________________________

MODEL NO. : ______________________________ ENGINE NO. : ______________________________
COLOR : ______________________________ PLATE NO. : ______________________________

The Deposit/Earnest Money is subject for forfeiture if the buyer fails to pay balance on or before the
due date.

“RECEIVED UNIT IN GOOD RUNNING CONDITION, AS IS WHERE IS CONDITION”

AGREED PRICE : PHP _____________ BALANCE : PHP _____________

DEPOSIT : PHP _____________ DUE DATE : JACCS FINANCE

Conforme:

___________________________

Seller’s Printed Name & Signature

ACKNOWLEDGEMENT RECEIPT
Received from Mr./Ms./Mrs. ______________________________________________ with address at
_____________________________________________________ the amount of
_________________________________________________________ PESOS (PHP _____________)
as Deposit/Earnest/Full Payment for one unit more particularly described as follows:

MAKE : ______________________________ CHASSIS NO.: ______________________________

MODEL NO. : ______________________________ ENGINE NO. : ______________________________
COLOR : ______________________________ PLATE NO. : ______________________________

The Deposit/Earnest Money is subject for forfeiture if the buyer fails to pay balance on or before the
due date.

“RECEIVED UNIT IN GOOD RUNNING CONDITION, AS IS WHERE IS CONDITION”

AGREED PRICE : PHP _____________ BALANCE : PHP _____________

DEPOSIT : PHP _____________ DUE DATE : JACCS FINANCE

Conforme:

___________________________

Seller’s Printed Name & Signature

Contact No.: _________________