Acknowledgement of Debt Sample

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ACKNOWLEDGEMENT OF DEBT

KNOW ALL MEN BY THESE PRESENTS:

I, ROBIN PADILLA, Filipino, of legal age, single / married to MYCHELL QUINTIA with postal
address at Brgy. Calero, Calapan City, Or. Mindoro witnesseth:

That I am indebted in the sum of Twenty Five Thousand PESOS (P: 25,000.00), Philippine
currency to ANGEL LOCSIN also a Filipino, of legal age, married with postal address at Green
Valley, Brgy. Damo, Calapan City, Oriental Mindoro.

That I shall pay the sum of TWENTY FIVE THOUSAND PESOS (P 25,000.00) unto the said
creditor (Ms. Minerva A. Acedillo) on May 13, 2018 or one month from the execution hereof,
with interest at the rate of Ten Percent (10.0 %) per month. In case of my failure to pay, my co-
maker, Ms. Vice Sayrit, Filipino and of legal age, shall assume the obligation of payment.

IN WITNESS WHEREOF I have affixed my signature hereto this _____ day of ____________, 20__
at ___________________________. at___________________________, Philippines.

ROBIN PADILLA VICE M. SAYRIT


Debtor Co-Maker

WITNESSES:

________________________ _______________________

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES)


_____________________________ ) SS.

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


the following:

Name CTC Number/ID Date/Place Issued

ROBIN PADILLA _____________________ ________________________


ANGEL LOCSIN ______________________ ________________________

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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