DEBT ACKNOWLEDGMENT AND PAYMENT OBLIGATION CONTRACT

This document is a PRIVATE CONTRACT OF ACKNOWLEDGEMENT OF DEBT AND

PAYMENT OBLIGATION entered into by, on the one hand, as CREDITORS, the marital
partnership formed by Mr. ___________________________, identified with DNI Nº
________, and Mrs. ________________ identified with DNI Nº _________, with common
domicile at ________________________ N° ____, district of ______, and on the other
hand, as DEBTOR , Mr. __________ identified with DNI N° ____________, with domicile
at ______________________________ N° ___, district of ___________ ; subject to the
following terms and conditions:

OF THE AMOUNT OF THE DEBT

FIRST: By signing this agreement, the DEBTOR expressly acknowledges owing to the
CREDITORS the agreed amount of US $ _______.00 (_____________ AMERICAN
DOLLARS).

THE FORM OF PAYMENT

SECOND : Having expressly acknowledged the debt, it is agreed that its cancellation shall
necessarily be made within a period of ________ months.
The term fixed in the preceding paragraph may be extended by agreement between the parties, using
any means that may be subject to simple confirmation.
A reduction in the term and/or an advance payment may also be established, provided there is
agreement between both parties.
It is also agreed that the repayment of the amount exchanged may be made exceptionally (upon
agreement of both parties) by means of payments on account, provided that THE CREDITORS so
request and THE DEBTOR is in a position to do so, establishing as of now that at that moment THE
DEBTOR would be obliged to pay the difference of the total amount within the term set forth in the
preceding clause, unless its extension is established at that moment.

OF INTEREST
THIRD: The parties agree that the amount recognized as debt shall not generate any
interest.

OF THE PAYMENT ORDER

FOURTH: Simultaneously to the signature of this contract, the parties subscribe one (01)
bill of exchange for the total amount of the debt, which will be cancelled once the debt is
paid in full.

JOINT GUARANTOR
FIFTH:
Intervene in the present contract in a personal capacity _________________, identified with D.N.I.Nº
_____________, who indicates domicile at _________________________ Nº ___, in the district of
__________, jointly and severally guaranteeing THE DEBTOR, with respect to each and every one
of the clauses of this contract, declaring his knowledge and total acceptance of the same, subscribing
in the same way the payment order described in the fourth preceding clause.

FIFTH: The parties expressly state that there has been no error, fraud, injury or
intimidation whatsoever in this contract.

Signed by the parties in agreement, in the city of Lima, on the _____ day of the month of
_____ of 20__.

_________________________________ _______________________________

THE CREDITOR THE CREDITOR

_________________________________ ______________________________________

THE DEBTOR THE GUARANTOR