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PAYMENT SLIP

Paym ent For ( K m a iy f i l i - o u i s*p»'ai* s 'lp 'o ' e a c o " x ) e O ' p a y m e n ii CABH OENOMINAWQN BR£AM>0WN

[ ~ } PESO BILI.INQ
COMPANV nam e ' LOAN TYPE ' SERVICE FEE
Q OOLLA« WLLINO
\omJ A A i 2. y ic> ri DENOMINATION PIECES AMOUNT

M A H ^A yX A V r z h t J t K FOP. HOCP/TAUTy/ A/^n /o o o ■TO.OOO -

Su b s c r ib e r ‘ c a r d h o l d e r s acc o u nt name REFERENCE NO 'CHECK NO

J0 MATHAK\ H- J A L M N Z A / < 2 2 . 2 C>/I


SUBSCRIBER NO CARD NO /SAP CUSTOMER NO 'LOAN ACCOUNT NO 'DEALER NO TELEPHONE NO 'OTHER OETAJLS

0 CA8M □ CHECK □ DEBIT ACCOUNT;


AutnoPzanon to Debit

AC C O U KTH O LDE fi'S S K jH A IU P C


-•V
AMOUNT |ir figuieei:
> r o / c o o ' TOTAL CASH PAYMENT ^O .O O Q -

PLEASE LIST EACH CHECK AND ENDORSE PROPERLY

BAN K /0 RANCH CHECK MO AMOUNT


234 HAGSAYGAY CE«TE 01/29/2019 14;5B .M PYUT ON IB
0232 348 29I38 PHP 50.000.00
JONATHAN K. JAINANZAL I . 000000 CS

TOTAL CHECK PAYMENT


V

THIS PAYMENT IS SUBJECT TO THE TERMS AND CONDITIONS COVERINC THIS ACCOUNT
THIS IS YOUR RECEIPT WHEN MACHINE VALIDATED
Me-i-M-213'Rev Oct V