ACKNOWLEDGEMENT OF DEBT 

 KNOW ALL MEN BY THESE PRESENTS:

I, ______________________________, Filipino, of legal age, single / married to ___________________________with postal addressat ___________________________________________________________ witnesseth:

That I am indebted in the sum of________ (amount in words) __________ PESOS (P: 000,000.000), Philippine Currency, to _________________________________________ also a Filipino, of legal age, single / married to _______________________________________ with postal address at ______________________________________________________.

That I shall pay the sum of _________________________________ PESOS (P 000,000.00) unto the said ____________________________ within a period of (state the repayment period - days/months/years)  from the execution hereof , with interest at the rate of (state the interest rate in words) ( 0.0 %) percent per year.

 IN WITNESS WHEREOF I have affixed my signature hereto this _____ day of ____________, 20__ at ___________________________. at___________________________, Philippines.

 _____________________________

(Printed Name Over Signature)

 WITNESSES:

 ________________________          _______________________

  

ACKNOWLEDGEMENT

 REPUBLIC OF THE PHILIPPINES)_____________________________ )  SS.

BEFORE ME, a Notary Public, this ____________day of ________________, personally appeared the following:

 Name                                CTC Number                Date/Place Issued

 (Name of Debtor)                        10000000               January 15, 20__ / Manila

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

Notary Public

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