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