DEED OF ACKNOWLEDGMENT OF DEBT

KNOW ALL MEN BY THESE PRESENTS:

I, _______, of legal age, Filipino, single, and with residence at __________, do hereby
depose and state:

1. I am indebted to ____________, of legal age, Filipino, single and with residence at

___________, in the amount of ____________ PESOS (Php.00), Philippine Currency.

2. I promise to pay the above-mentioned amount unto ____________ in monthly

instalments from January 2023 to December 2023, in accordance to the following
schedule:

3. I will pay the above-mentioned amounts through online bank transfer and/or deposit
of such amounts to _______’s preferred bank account.

4. I acknowledge and understand that in case I fail to pay any instalment due, the entire
loan amount shall, at the option of ____________, be due and demandable, without the
necessity of demand or notice to me.

          IN WITNESS WHEREOF, I have affixed my signature hereto this ___________ 2023 at
_________, Philippines.

____________
Debtor

Witnesses:

______________________ ______________________

ACKNOWLEDGMENT

REPUBLIC OF THE PHILIPPINES)

)SS

BEFORE ME, Notary Public, for and in __________, this _________2023, personally
came and appeared:

NAME VALID GOV’T ID DATE/PLACE ISSUED

known to me to be the same person who executed the foregoing instrument and acknowledged
to me that the same is their own free voluntary act and deed, consisting of one (1) page
including this page on which the Acknowledgment is written and duly signed by the parties
and their instrumental witnesses.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2023.