DEED OF ACKNOWLEDGMENT OF DEBT

KNOW ALL MEN BY THESE PRESENTS:

I, ______________________________________________________, (“DEBTOR”) of legal
age, Filipino, married to ______________________________________and a resident of
____________________________________________________________, after being duly
sworn to in accordance with law, witnesseth and declare:
That I am indebted in the total sum of Three Hundred Thirteen Thousand Pesos Only (Php
313,000.00), Philippine Currency, representing the total outstanding principal loans that I/We
borrowed on several occasion, to wit;

Php 180,000.00
Php 50,000.00
Php 33,000.00
Php 50,000.00

to MRS. FELISA E. STA. MARIA, (“CREDITOR”) who is also of legal age, widow, and a
resident of 75 xxxxxxxxxxxxxxxxxxxxx.

That I hereby promise and undertake to pay the said indebtedness unto the said Felisa E. Sta.
Maria or to her representatives within a period of __________________________ (_____)
(months/years/days) from today, in the amount of _____________ (P_____________)
(monthly) every _____________________ until fully paid.

That I/We are fully aware that our failure to settle the said amount subject to the above
agreement shall warrant a legal action to collect without any further need of a written demand
from the CREDITOR or her representatives.

IN WITNESS WHEREOF, I have hereunto set my hand this _________________________in

Marikina CIty, Philippines.

AFFIANT
With Marital Consent

___________________________________

SIGNED IN THE PRESENCE OF:

_____________________________________ ____________________________________

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 ACKNOWLEDGEMENT

 
REPUBLIC OF THE PHILIPPINES)
___________________________ )  SS.

BEFORE ME, a Notary Public, this ____________day of ________________, personally

appeared or have shown competent proof of identity the following:
 
Name                               ID Number                Date/Place Issued
 

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

Notary Public

Doc. No. .......;

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

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