P1,000

(Date)

______ days after date, pay the order of OURSELVES the sum of ONE THOUSAND
PESOS (P1,000), Philippine currency, payable at the Philippine National Bank, Manila.

(This obligation of the acceptor hereof arises out of the purchase of goods from the
drawer)

____________________
(Drawer)

To: ______________________
(Name of drawee or buyer)

ACCEPTED at ______ on _________

(Sgd.) DRAWEE-ACCEPTOR