affidavit of acknowledgement receipt form.doc

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KASUNDUAN SA UPA NG BAHAY

PAGE 2

REPUBLIC OF THE PHILIPPINES)Taguig City

)Sc.

ACKNOWLEDGEMENT RECEIPT WITH

RELEASE OF FINANCIAL OBLIGATION

We, SPOUSES EDWIN MAMARIL and RODORA MAMARIL, both of legal age, and residents of 331A Medel St. Zone 3 Signal Village, Taguig City after having been duly sworn in accordance with law, hereby depose and state:

1. That we received the amount of EIGHT HUNDRED NINETY THREE THOUSAND TWO HUNDRED PESOS (Php 893, 200.00) from PAULINO CAMBA JR. represented by IVY M. CAMBA;2. That said amount represents full payment and satisfaction of the Promissory Note which was executed on June 06, 2013;3. That MR. PAULINO CAMBA JR. is now released from all of his financial obligation from me and the Promissory Note executed by Mr. Paulino Camba is now null and void;4. That I am executing this affidavit to attest to the truthfulness of the foregoing narration of facts and for all legal intents and purposes it may best serve.

IN WITNESS WHEREOF, we have hereunto set our hands this July 16, 2015, in Taguig City. EDWIN MAMARIL RODORA MAMARIL

Affiant Affiant DL no. N02-97-348012 SSS # 03-9383097-4

IVY M. CAMBA For PAULINO CAMBA JR.

Affiant

PRC Lic. No. 118694

SUBSCRIBED AND SWORN TO BEFORE ME this July 16, 2015, in Taguig City. Affiants personally appeared all parties including their competent proof of identity recorded below their names.