Sample Format Acknowledgment Receipt

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ACKNOWLEDGMENT RECEIPT

KNOW ALL MEN BY THESE PRESENTS:


I,
__________________,
of
single/married/widow/widower,
Filipino,
_______________:

legal
and

age/senior
citizen,
a
resident
of

--Witnesseth
That I have received from ______________, the sum of
_________________________
PESOS
(Php
_____________________) Philippine currency, in full payment to my
complete satisfaction of my property, under Original/Transfer Certificate of
Title No. __________, located at _______________.
IN WITNESS WHEREOF, I have affixed my signature hereto this
______________________________
at
____________________,
Philippines.
________________
____
Affiant
WITNESSES:
________________________

____________________

SUBSCRIBED AND SWORN TO before me this ____ day of


_________________, by _____________, who exhibited to me his/her ID
No. _________________, issued on ________________, issued at
_______________________, known to me to be the same person who
acknowledged before me the above instrument.
WITNESS
my
hand
__________________________________
Philippines.

and
seal
this
at
_________________,

Notary Public
Valid until 31
20___
Doc No.
Page No.
Book No.
Series of 2015.

December

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