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Official Receipt

OR NO	PDC NO	DATE	CUSTOMER	OR TYPE	BANK	CR NO.	AMOUNT

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PDC Entry No

	Invoice No	Amount

Total P

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OR No.

OR No. Issued

Date

Received From

Address

The Sum Of

(P)

TIN

Signatory

Withheld Tax Rate (%)

Withheld Tax Amount

With EWT Certificate

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EWT Received Date

Payment Type

Account Cash

OR Type

Bank

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OR No	Customer Name	EWT Received