DEED OF ACKNOWLEDGMENT OF DEBT

KNOW ALL MEN BY THESE PRESENTS:

I, ____________________________, of legal age, Filipino, (single / married /

widow / widower), and a resident of ____________________________, after being
duly sworn to in accordance with law do hereby declare:

That I am indebted in the sum of _____________________________

(PHP___________________________), Philippine Currency, to
_______________________________, who is also of legal age, (single / married /
widow/widower), 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 _____________ (_____%) percent per (month/annum) until fully paid.

IN WITNESS WHEREOF, I have hereunto set my hand this _______________

in _________________, Philippines.

______________________________
Debtor
ID NO.____________________

SIGNED IN THE PRESENCE OF:

_________________________ _________________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

_________________________)

BEFORE ME, a Notary Public for and in _________________, this

__________________, personally appeared herein above-named debtor with his/her
IDENTIFICATION DOCUMENT as indicated below his/her name, known to me and to me
known to be the same person who executed the foregoing instrument and
acknowledged that the same is his/her own, free, voluntary act and deed.

WITNESS MY HAND and NOTARIAL SEAL at date and place above written.

Doc. No. ____;

Page No. ____;
Book No.____;
Series of ____.