ACKNOWLEDGEMENT OF DEBT

KNOW ALL MEN BY THESE PRESENTS:

I, __________________________________________________, Filipino, of legal age, single /
married to ____________________________________with postal address at
_____________________________ __________________________________________ witnesseth:
That I am indebted in the sum of_________________________________________ PESOS
(P________), Philippine Currency, to ___________________________________________ also a
Filipino, of legal age, single / married to _______________________________________ with
postal address at ______________________________________________________________.
That I shall pay the sum of _________________________________________ PESOS
(P________), unto the said ______________________________________ within a period of
____days/months/years from the execution hereof, with interest at the rate of
_________________ (___ %) percent per day/month/year or
____________________________________________________________________
_________________________________________________________ (as agreed upon).
IN WITNESS WHEREOF I have affixed my signature hereto this _____ day of
____________, 20__ at _______________________________________________________,
Philippines.

_____________________________
(Printed
Name Over Signature)
WITNESSES:
________________________

_______________________
ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)

_____________________________ ) SS.
BEFORE ME, a Notary Public, this ____________day of ________________, personally
appeared the following:
Name

ID/CTC Number

Date/Place Issued

IN WITNESS WHEREOF, I have hereunto set my hand the day, year and place above
written.
Notary Public
Doc. No. .......;
Page No. .......;

Book No. .......;

Series of 20__.