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Promissory Note Sample

Juan Dela Cruz signed a promissory note agreeing to pay Community Hospital P15,841.50 for medical services provided to Maria Dela Cruz from October 29 to December 31, 2018. The note states that Juan executed it voluntarily and understands he must pay the full amount by December 31 in Tagbilaran City, and that legal disputes will be settled in courts there.

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1K views1 page

Promissory Note Sample

Juan Dela Cruz signed a promissory note agreeing to pay Community Hospital P15,841.50 for medical services provided to Maria Dela Cruz from October 29 to December 31, 2018. The note states that Juan executed it voluntarily and understands he must pay the full amount by December 31 in Tagbilaran City, and that legal disputes will be settled in courts there.

Uploaded by

john_laga
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Promissory Note

(P15,841.50)

For value received, I, JUAN DELA CRUZ, Filipino, of legal age, single and
resident of ________________, Philippines, hereby promise to pay to the order of
COMMUNITY HOSPITAL with address at ________________, the amount of
FIFTEEN THOUSAND EIGHT HUNDRED FORTY ONE PESOS AND 50/100
(P15,841.50), Philippine Currency, as the final billing of hospital billing for the patient,
MARIA DELA CRUZ, who was admitted on October 29, 2018, under Admission No.
99999, 22 years of age, and that the total amount of loan or balance shall be paid on not
later than the 31st of December, 2018 without the need of further demand;

That, I, JUAN DELA CRUZ am executing this instrument of my own free will
and volition and with full understanding of the effect and consequences of my action.

It is expressly agreed that all legal actions arising out of this note or in collection
thereof, shall only be brought in or submitted to the jurisdiction of the proper court in
Tagbilaran City.

IN WITNESS WHEREOF, I have hereunto set my hand this 14th day of


November 2018 in ________________.

JUAN DELA CRUZ


Driver’s Lic. No. 99-9999-999
Debtor

SUBSCRIBED AND SWORN to before me this 14th day of November 2018 in


Tagbilaran City, Bohol, Philippines.

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