TYPE HERE YOUR COMPANY
TYPE HERE YOUR ADDRESS
TYPE HERE YOUR 12 DIGIT T.I.N. NO.
PROVISIONAL RECIEPT
NO.:
DATE :
January 31, 1999
RECEIVED from
address
the sum of
( P 99,999,999,999.00 )
as full / partial payment of
FORM OF PAYMENT
By:
CASH
( P 99,999,999,999.00 )
CHECK ( P 99,999,999,999.00 )
Authorized Signature
BANK
CHECK NO.:
TYPE HERE YOUR COMPANY
TYPE HERE YOUR ADDRESS
TYPE HERE YOUR 12 DIGIT T.I.N. NO.
NO.:
PROVISIONAL RECIEPT
( DUPLICATE COPY )
DATE :
January 31, 1999
RECEIVED from
address
the sum of
( P 99,999,999,999.00 )
as full / partial payment of
FORM OF PAYMENT
By:
CASH
( P 99,999,999,999.00 )
CHECK ( P 99,999,999,999.00 )
BANK
CHECK NO.:
Authorized Signature