AFFIDAVIT OF ACKNOWLEDGEMENT

AND UNDERTAKING
REPUBLIC OF THE PHILIPPINES
CITY OF CAGAYAN DE ORO

)
)S.S.

I, CHARLIE C. ANDOY, of legal age, married, and a resident of

Poblacion, Damulog, Bukidnon, after having been sworn in accordance with
law, depose and says;
1. That on date herein provided, I hereby ACKNOWLEDGE to have
receive the amount of THREE HUNDRED FIFTY NINE THOUSAND
TWO HUNDRED FIFTY PESOS (P359,250.00) from Ms. Gladys Q.
Gaccion;
2. That upon receipt hereof, and as guarantee for the performance of
my obligation to pay the above amount, I have caused the issuance
of the following Post Dated Checks, to wit;
Check no.
____________
Date on check. ____________
Amount
____________
Drawee Bank
____________
Name of Payee ____________
3. That I hereby acknowledged and understood that the above
mentioned amount would not have been released by Ms. Gladys Q.
Gaccion had it not for the issuance of the above Post Dated Checks;
4. That I hereby GUARANTEE, UNDERTAKE AND PROMISE that the
above mentioned checks are sufficiently funded and said funds will
be maintained at the time each check shall fell due;
5. That I have executed this affidavit to attest the truthfulness of the
foregoing facts and for whatever legal purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this ___________ in
the City of Cagayan de Oro, Philippines.

_____________________
Affiant
I.D. presented ______________

SUBSCRIBED AND SWORN to before me on the above mentioned date

and place by the affiant herein, known to me to be the same person who
executed the above affidavit.

TRUST RECEIPT
KNOW ALL MEN BY THESE PRESENTS;
I, CHARLIE C. ANDOY, (ENTRUSTEE) of legal age, married, and a
resident of Poblacion, Damulog, Bukidnon, acknowledge to have received
from Ms. Gladys Q. Gaccion (ENTRUSTER) the following items, to wit;
ITEM (DESCRIPTION)
Fertilizer 16-20-00
Fertilizer Urea
Fertilizer 21-00-00
Total

QUANTITY
120 bags
100 bags
50 bags

VALUE
P192,000.00
P128,000.00
P 39,250.00
P359,250.00

Terms and conditions:

1. That the above items have been received for purposes of disposing
or selling the same for cash or otherwise.
2. That the total cash value of the items whether disposed or not by
the entrustee shall be returned to the entruster ONE HUNDRED
TWENTY (120) days from date hereof.
3. That a post-dated check shall be issued by the entrustee in favor to
the entruster as security for the performance of her obligation to
return the above mentioned amount.
IN WITNESS WHEREOF, I have hereunto set
________________ in the City of Cagayan de Oro, Philippines.

my

hand

this

CHARLIE C. ANDOY,
(ENTRUSTEE)
Signed in the presence of:
____________________________

__________________________

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES
)
CITY OF CAGAYAN DE ORO
) S.S
BEFORE ME a notary Public for Cagayan de Oro City, this _____ day of
__________, 2015, personally appeared the above named person, her
community tax certificate indicated below her name above, known to be and
to me to be the same person who executed the foregoing Deed consisting of
one (1) page including this page wherein the acknowledgement is written,
and acknowledge to me that the same is their free act and deed and that of
the person they represent.

Doc. No.__________
Page No.__________
Book No. _________
Series of._________