RECEIPT OF FUNDS
Date
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
TOTAL AMOUNT RECEIVED / إجمالي المبلغ المستلم
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CURRENCY
*
Name :
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Full Phone Number:
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Email:
*
THE EMAIL MUST BE VALID
ID NUMBER
*
ID or Driver liscence or passport(FRONT PAGE)
*
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I, the undersigned, hereby acknowledge that I have received the above amount from Dr. Mostafa Osama Mahmoud Abdalla and/or the relevant company in full. I confirm that the payment amount stated above has been received and credited to me, and I have verified the amount personally. I understand that this document serves as proof of payment and may be retained electronically by the company for accounting, payroll, audit, legal, and record-keeping purposes. I confirm that the information provided in this acknowledgement is true and correct.
Selfie Photo with ID ✅
*
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Signature
*
Appointment
*
SUBMIT
SUBMIT
location
Should be Empty: