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DATE: 05/25/2022
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TEL:
ORDER#
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CUSTOMER COPY
DATE: 05/25/2022
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RIDER SIGNATURE ________________________
ACKNOWLEDGEMENT RECEIPT
ACK#
STORE COPY
DATE: 05/25/2022
IN SETTLEMENT OF THE FOLLOWING
ORDER#
AMOUNT
P
FORM PAYMENT
AMOUNT
P
RECEIVED FROM:
ADDRESS AT
109 KANLAON STREET STA. MESA HEIGHT QC
THE SUM OF P
1,275.00
IN PARTIAL/FULL PAYMENT FOR
ORDER#
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BY: _________________________________
THIS DOCUMENT IS NOT VALID FOR CLAIMING INPUT TAXES
ACKNOWLEDGEMENT RECEIPT
ACK#
CUSTMER COPY
DATE: 05/25/2022
IN SETTLEMENT OF THE FOLLOWING
ORDER#
AMOUNT
P
FORM PAYMENT
GCASH
AMOUNT
P
RECEIVED FROM:
ADDRESS AT
109 KANLAON STREET STA. MESA HEIGHT QC
THE SUM OF P
1,275.00
IN PARTIAL/FULL PAYMENT FOR
ORDER#
- MO
BY: _________________________________
THIS DOCUMENT IS NOT VALID FOR CLAIMING INPUT TAXES
