Acknowledgement of receipt

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Acknowledgement of receipt

  1. 1. REPUBLIC OF THE PHILIPPINES )PROVINCE OF KALINGA ) S.S.MUNICIPALITY OF TABUK ) ACKNOWLEDGEMENT RECEIPT I, _____________, of legal age, married to ___________________,Filipino Citizen and a resident of ___________________, hereby authorized byAndres Garcia under Special Power of Attorney executed by Atty._________________ Notary Public and entered in Doc. No: 483 , Page No. 97;Book No. 6 ; Series of 2005 to use and offer as a collateral the property coveredby Transfer Certificate of Title No. T-16928 in the name of Andres Garciacontaining an area of Two Hundred Forty Five (245) Square Meters situated at__________________(address) to __________________________________Association Inc., with a loan in the amount of _____________________Philippine Currency with a Monthly Interest of Five Percent (5%f) beginning forthe month of _____________(date) until the Principal amount will return fromthe Association. IN WITNESS WHEREOF, we hereunto set my hand this _______ day of_____________, 2005 at Tabuk, Kalinga, Philippines.BY __________________________________________ _________________________ (President) (Borrower) ____________________________ (Treasurer)SIGNED IN THE PRESENCE OF:_______________________________ _________________________ SUBSCRIBED AND SWORN TO before me this ________ day January, 2005 atBulanao, Tabuk, Kalinga.DOC NO. _______PAGE NO. ______BOOK NO. ______SERIES 2005

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