DEED 

OF ACKNOWLEDGMENT OF DEBT
KNOW ALL MEN BY THESE PRESENTS:
I, _____________, of legal age, Filipino, (single / married / widow), and a
resident of _____________, after being duly sworn to in accordance with law,
witnesseth and declare:
That I am indebted in the sum of _____________ (P_____________), Philippine
Currency, to _____________, who is also of legal age, (single / married / widow),
and a resident of _____________.
That I hereby promise and undertake to pay the said indebtedness unto the said
_____________ within a period of _____________ (_____) (months/years/days)
from today, in the amount of _____________ (P_____________) (monthly/daily)
every _____________ with interest at the rate of _____________ (_____%) per
centum per (month/annum) until fully paid.
IN WITNESS WHEREOF, I have hereunto set my hand this _____________ in
_____________, Philippines.
AFFIANT

SIGNED IN THE PRESENCE OF:

_________________ __________________

(ACKNOWLEDGMENT)