No.

5811, Street 1992, Bayab Village, Sangkat Phnom Penh Thmey,

Khan Sen Sok, Phnom Penh, Kingdom of Cambodia

Debt Acknowledgment Letter

Date...........Month...................Year.................

As the accounting staff has audited ......................................................................................................

Date...........Month...................Year................. it appeared that .........................................................................................
That is amount ......................................dollars (..........................................................................) Which the
accounting staff has notified to (Mr./Mrs./Miss) .......................................................................... to be
acknowledged the details.

Therefore, I would like to acknowledge the said debt and agree to allow the company to deduct a
salary for ………………times with amount of ......................... (……………………………………………………) Baht
per installment, starting on............................................................. until..................................................................

If (Mr./Mrs./Miss) ..........................................................................resign before completing the payment term.

The company reserves the right to deduct the remaining amount from the employee's income
according to the total remaining outstanding debt. If the employee's income is not sufficient to
cover the remaining balance, the employee will be required to make the payment to the Company
until the total amount is settled.

I, (Mr./Mrs./Miss) …………………………….. consent to provide a personal guarantee for the Debt

Acknowledgment Agreement as a commitment to guarantee the payment of the outstanding
amount for (Mr./Mrs./Miss) ……………………………………… according to the document no……………… of
the Company.
If (Mr./Mrs./Miss) is unable to make the payment to the Company, I, as the guarantor, agree to
settle the outstanding amount on their behalf until the full amount owed is paid to the Company as
per the Debt Acknowledgment Agreement.

Signature ...........................................................Debtor (Employee)

(................................................................)

Signature ........................................................... Creditor (Company)

(................................................................)

Signature ........................................................... witness

(................................................................)

Signature ........................................................... witness

(................................................................)