REPUBLIC OF THE PHILIPPINES
REGIONAL TRIAL COURT
National Capital Judicial Region
BRANCH ____
________________ CITY
January xx, 2020
ORDER OF PAYMENT
ATTY. ___________
Clerk of Court
Office of the Clerk of Court-Regional Trail Court
_______ City
SIR/MADAM:
Please accept the payment of ATTY. ________________, in the
amount of One Thousand Pesos (Php 1,000.00), Philippine Currency, as fine
for the late filing of Judicial Affidavit in Civil Case No.
________________________ pursuant to the Order issued by this Court
dated ____________________.
JUAN DELA CRUZ
Court Interpreter