For value receiver, I ________________________________________________ age ____
Civil status ________ current contact number ________________ and a resident of ______________________________. Make commitment to pay 500 pesos every fifteen days. If able to receive the unit ____________________ early or ahead of time, I still have to pay until 10 months is over. IN WITNESS WHEREOF, I set my hand to affix my signature as a result of the foregoing.
__________________________ Date of Release: _________