ACKNOWLEDGEMENT OF DEBT

With Promissory Note

KNOW ALL MEN BY THESE PRESENTS:

I, GANDA N. DILAG, Filipino, of legal age, married to Pogi G. Dilag resident of

Tagaytay, Camalig, Albay.

WITNESSETH:

That I am INDEBTED in the sum of EIGHTY-TWO THOUSAND ONE HUNDRED

TWENTY PESOS (₱82,120.00), Philippine Currency to ANABEL CHORVA.

That I PROMISE to pay the sum of EIGHTY-TWO THOUSAND ONE HUNDRED

TWENTY PESOS (₱82,120.00), Philippine Currency with no interest on December 30, 2023.

IN WITNESSS WHEREOF, I have hereunto signed this instrument this _____ day of
____________________ at Camalig Albay, Philippines.

GANDA N. DILAG
Debtor

ANABEL CHORVA
Creditor

SIGNED IN THE PRESENCE OF:

ACKNOWLEDGEMENT

Republic of the Philippines )

Province of Albay S.c
Municipality of Camalig )

Before me, this ___ day of __________________ in the municipality of Camalig personally
appeared the foregoing parties identified by their government-issued identification card
bearing no. _________________ and ___________________ to known to me to be the same
persons who executed the foregoing instrument and acknowledged to me that the same is their
free act and voluntary deed.

IN WITNESS WHEREOF, I have hereunto set my hand, the day, year and place above-written.

Doc. No. ___;

Page No. ___; Notary Public
Book No. ___;
Series of ____.

Page 1 of 1