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________ (amount in words) __________ PESOS

(P__________), Philippine Currency, to also Filipino citizens, of legal age, married
with postal address at
______________________________________________________.

That I shall pay the sum of _________________________________ PESOS (P

____________) per month unto the said ___________________________within a
period of ____________________ (state the repayment period -
days/months/years) from the execution hereof.

IN WITNESS WHEREOF I have affixed my signature hereto this _____ day of

____________, 20__ at ___________________________. 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 CTC Number Date/Place Issued

(Name of Debtor) 10000000 January 15, 20__ / Manila

(Name of Creditor) 10000000 February 24, 20__ / Pasig

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 2018.