ACKNOWLEDGMENT OF DEBT
KNOW ALL MEN BY THESE PRESENTS:
I, ______________________________, Filipino, of legal age, single / married to ___________________________with postal address at ___________________________________________________________ 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)
REPUBLIC OF THE PHILIPPINES)
BEFORE ME, a Notary Public, this ____day of ________________, personally appeared the following:
Name CTC Number Date/Place Issued
(Name of Debtor) 0000000 March 2, 20__/ Quezon City
(Name of Creditor) 0000000 April 4, 20__ / Makati City
IN WITNESS WHEREOF, I have hereunto set my hand the day, year and place above written.
Doc. No. .......;
Page No. .......;
Book No. .......;
Series of 20__.