(Chattel Mortgage Without Separate Promissory Note)

CHATTEL MORTGAGE

KNOW ALL MEN BY THESE PRESENTS:

This Chattel Mortgage, made by and between:

_____________, of legal age, (single / married / widow), and a resident of

_____________, Philippines (hereinafter known as the MORTGAGOR);

- and -

_____________, of legal age, (single / married / widow), and a resident of

_____________, Philippines (hereinafter known as the MORTGAGEE);

WITNESSETH; That:

The MORTGAGOR is indebted unto the MORT-GAGEE in the sum of _____________

(P__________), Philippine Currency, receipt of which is acknowledged by the
MORTGAGOR upon the signing of this instrument, payable to the order of the MORGAGEE
without need of prior demand or notice within a period of _____________
(years/months/weeks/days), at _____________ (P__________) (monthly/weekly/daily)
starting on _____________ and on every _____________ thereafter until fully paid,
with interest thereon at the rate of _____________ (______%) percent per
(month/annum).

NOW, THEREFORE, for and consideration of the afore-mentioned indebtedness, and to

assure the performance of said obligation to pay, the MORTGAGOR hereby conveys by
way of CHATTEL MORTGAGE unto the MORTGAGEE, (his/her) heirs, successors and as
signs, the following personal property now in the possession of said MORTGAGOR:

(Description of the Subject Personal Property)

That it is the condition of this Mortgage that should the MORTGAGOR perform the
obligation to pay the afore-cited indebtedness of _____________ together with
accrued interest thereon, within the agreed term, this Chattel Mortgage shall be
discharged and shall at once become null and void and of no effect whatsoever,
otherwise, it shall subsist and remain in full force and effect and be subject to
foreclosure in the manner and form prescribed by law.

IN WITNESS WHEREOF, we have have hereunto set their hands, this _____________ at
_____________, Philippines.

MORTGAGOR MORTGAGEE

With my Marital Conformity:

Mortgagor's Spouse

SIGNED IN THE PRESENCE OF:

_________________ _________________

(ACKNOWLEDGMENT)

Affidavit of Good faith

We, the undersigned MORTGAGOR and MORTGAGEE hereby jointly and severally swear that
we executed the foregoing Chattel Mortgage in order to secure the indebtedness
therein cited and for no other purpose or purposes contrary to law.

MORTGAGOR MORTGAGEE

(JURAT)