ACKNOWLEDGEMENT OF DEBT CUM PROMISSORY NOTE

FOR VALUE RECEIVED, I, _________________________ promise to pay _____ of

legal age, Filipino citizen and a resident of P2 Central Poblacion, bakbak city the principal
sum of PESOS: ONE MILLION FOUR HUNDRED FORTY-FIVE THOUSAND PESOS
(1,445,000.00) Philippine Currency, WITHOUT INTEREST, payable within two (2) years for
the installment of PESOS: THIRTY THOUSAND PESOS (P30,000.00), the first installment to
become due on August 2013 and the succeeding installments to fall due monthly
thereafter, until the whole sum shall have been fully paid.

In case of non-payment of this note, I agree to pay an additional amount equivalent

to five percent (5%) per month based on the total amount due and demandable as penalty,
until paid; and the further sum of twenty-five percent (25%) thereof as and for attorney’s
fees exclusive of cost and judicial/extra-judicial expenses.

DEMAND AND NOTICE OF DISHONOR WAIVED. Holder(s) may accept partial

payments(s) and grant renewals or extensions of payment. Acceptance by holder(s) hereof
any partial payment(s) hereof any partial payments(s) after due date shall not be
considered as extending the time for payment or as a modification of any conditions hereof.

This is note shall be governed by Philippine laws. If any provision hereof is declared
null and void or unenforceable for any reason by a court of competent jurisdiction, then the
validity, legality and enforceability of the provision shall not be affected nor impaired.

I/WE HEREBY AFFIRM AND CONFIRM THAT PRIOR TO EXECUTING THIS NOTE, I
HAVE READ AND UNDERSTOOD THE CONTENTS HEREOF, AND AGREE TO BE BOUND FULLY
AND UNCONDITIONALLY TO THE TERMS AND CONDITIONS HEREOF AND THE SAME IS
BINDING AND ENFORCEABLE AGAINST ME IN ACCORDANCE HEREWITH.

Principal Borrower/Debtor

SIGNED IN THE PRESENCE OF:

Witness Witness

REPUBLIC OF THE PHILIPPINES )

PROVINCE OF ) S.S
MUNICIPALITY OF )

At the Municipalityof _____________ Province of _________ this ______________

the following persons personally appeared and exhibited to me their respective valid
identification cards and/or Community Tax Certificates, to wit:
Valid I.D/CTC No: Issued on/at:

Known to me to be the same persons who executed the foregoing instrument, consist of one
(1) page including this page on which this acknowledgment is written and signed at the left
margin of each and every page by the parties executing this instrument and their witnesses,
and sealed with my notarial seal and that said parties acknowledged to me that the same is
their own free act and voluntary deed.

WITNESS MY HAND AND SEAL on the date and place first written above.

Doc. No. : ____;

Page No.: ____;
Book No.:_____;
Series of 2013....