Free acknowledgment receipt template
An acknowledgment receipt format for the Philippines showing who paid, the amount in words and figures, what it is for and whether it is partial or full payment, with a payer's copy and a payee's copy. Sample receipt included.
What's in this template
Acknowledgment receipt
Payer's copy · No. AR-2026-0147
| Date | 28 October 2026 |
|---|---|
| Place | Davao City |
I, ERLINDA V. CABRERA, of legal age, Filipino, owner of the house and lot at Blk 5 Lot 11, Ecoland Subdivision, Barangay Matina Crossing, Davao City, Davao del Sur 8000, hereby acknowledge receipt from MR. DENNIS R. ABELLANA, residing at 78 Juna Avenue, Barangay Matina Aplaya, Davao City 8000, of the sum of:
FORTY-FIVE THOUSAND PESOS ONLY (₱45,000.00)
| For payment of | Rent for November 2026 (₱15,000.00) and two months' security deposit (₱30,000.00) for the unit at Blk 5 Lot 11, Ecoland Subdivision |
|---|---|
| Mode of payment | BDO Cheque No. 0045182, dated 28 October 2026 |
| Payment | ☐ Partial ☒ Full |
| Balance, if any | ₱0.00 |
| Received by (payee) | Paid by (payer) |
|---|---|
| ____________________ | ____________________ |
| Erlinda V. Cabrera | Dennis R. Abellana |
| 0917 702 1184 | 0920 455 8317 |
Witness: ____________________ Grace Ann T. Pepito
Acknowledgment receipt
Payee's copy · No. AR-2026-0147
| Date | 28 October 2026 |
|---|---|
| Place | Davao City |
I, ERLINDA V. CABRERA, of legal age, Filipino, owner of the house and lot at Blk 5 Lot 11, Ecoland Subdivision, Barangay Matina Crossing, Davao City, Davao del Sur 8000, hereby acknowledge receipt from MR. DENNIS R. ABELLANA, residing at 78 Juna Avenue, Barangay Matina Aplaya, Davao City 8000, of the sum of:
FORTY-FIVE THOUSAND PESOS ONLY (₱45,000.00)
| For payment of | Rent for November 2026 (₱15,000.00) and two months' security deposit (₱30,000.00) for the unit at Blk 5 Lot 11, Ecoland Subdivision |
|---|---|
| Mode of payment | BDO Cheque No. 0045182, dated 28 October 2026 |
| Payment | ☐ Partial ☒ Full |
| Balance, if any | ₱0.00 |
| Received by (payee) | Paid by (payer) |
|---|---|
| ____________________ | ____________________ |
| Erlinda V. Cabrera | Dennis R. Abellana |
| 0917 702 1184 | 0920 455 8317 |
Witness: ____________________ Grace Ann T. Pepito
Find it in: Acknowledgment receipt sample · Promissory note sample