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PROMISSORY NOTE with UNDERTAKING

Tagbilaran City
11 December 20XX

=P= 33,600.00

FOR VALUED RECEIVED, I, ABC, Filipino, of legal age, single, and a resident of
XXX, Tagbilaran City, Bohol, Philippines, hereby promise to pay to THE ORDER OF XYZ,
Filipino, of legal age, single and a resident of XXX, Tagbilaran City, Bohol, Philippines,
the amount of THIRTY THREE THOUSAND SIX HUNDRED (P=33,600.00) PESOS payable
within a period of SIXTY DAYS starting on 19 December, 20XX with a weekly installment
of P4,200.00 payable in eight installments until the whole amount is fully settled on or
before 06 February, 20XX, whichever comes first, without the need of further demand.
In case of failure to pay for two installments, the whole amount of the loan shall
become due and demandable.

I further issue by way of security for the payment of the aforesaid loan the
following postdated checks:

Check No. Amount

Allied Bank Check No. XXX dtd 12/19/XX 4,200.00
Allied Bank Check No. XXX dtd 12/26/XX 4,200.00
Allied Bank Check No. XXX dtd 01/02/XX 4,200.00
Allied Bank Check No. XXX dtd 01/09/XX 4,200.00
Allied Bank Check No. XXX dtd 01/16/XX 4,200.00
Allied Bank Check No. XXX dtd 01/23/XX 4,200.00
Allied Bank Check No. XXX dtd 01/30/XX 4,200.00
Allied Bank Check No. XXX dtd 02/06/XX 4,200.00

IN WITNESS WHEREOF, We have hereunto set our hand this _____________ in

the City of Tagbilaran, Bohol, Philippines.

ABC XYZ
LENDER BORROWER

WE, the undersigned, hereby jointly and severally bind ourselves to pay to the
order of ABC the amount of THIRTY THREE THOUSAND SIX HUNDRED (P=33,600.00)
PESOS in case XYZ defaults in paying the aforesaid amount when it becomes due.

The above-stated undertaking is translated to us and is fully understood before

we affix our signatures. We bind ourselves to faithfully comply the same, and in the
event of collection by a lawyer, 25% attorney’s fees shall be paid by us and the venue of
Courts is Tagbilaran City.

EFG HIJ KLM

Co-maker Co-maker Co-maker
 2

SIGNED IN THE PRESENCE OF:

1. _______________________________ 2. ____________________________

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES)
TAGBILARAN CITY ) S. S.

At Tagbilaran City, on _________________, personally appeared before me:

Name Proof of identity

ABC PhilHealth ID No. XXXXX
XYZ PhilHealth ID No. XXXXX
EFG PhilHealth ID No. XXXXX
HIJ PhilHealth ID No. XXXXX
KLM PhilHealth ID No. XXXXX

known to me to be the same persons who executed the foregoing instrument and they
acknowledged that the same is their free act and deed.

WITNESS my hand and seal on ______________ at Tagbilaran City, Philippines.

Doc. No. ___;

Page No. ___;
Book No. ___;
Series of 20__;