Sunro Change B.V.

Damrak 17 1012 LH Amsterdam Tel : 020 4270260 Fax : 020 6265184 E-Mail : sunro@xs4all.nl

23-apr-2012 13:49

ABN

Remitter's Information Form 201223348 - Metrobank

Name: Address: Postcode/Plaats: Date of birth: Telephone Nr.Home: Mobile: Job: Source of income: Purpose of money: 06-46223833 23 Apr : STAMPCARD 2 : STAMP 4 REFERENCE NUMBER: 201223348 Udo, Wouter Leendert Groep Welterhof 17 1318 CM Almere 03-May-1965 Male Identification: Number: Date of Issue: Expiring date: Place of Issue: Nationality: Passport NY3LFLLB9 09-jun-2011 09-aug-2015 Almere NL: amsterdam

Remittance amount: 80,00

+ service charge: 10,0 55,35

= Total amount in Euro: Total amount in Peso:

90,00 4428,00

Exchange rate (Euro to Phil.Peso):

Beneficiary Information 1
Name: Address: City: Provence Telephone: Mobile: 09277308620 BankToBank Espinosa, Rudissa O.

Door to Door BankName: Password: Branch:

Notify and pay

M. LHUILLIER Ref No pick up anywhere

I certify and agree that I have read the terms and conditions.

Remitter's signature

Cashier signature

Rona Waldron