DECLARATION 50K Above 1

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DECLARATION / IRREVOCABLE AUTHORIZATION

KNOW ALL MEN BY THESE PRESENTS:

That I, maker , of legal age, Filipino, and a resident of


________________________________________________________have
address obtained a loan dated ________________________
date from
Amount in words
the Paltok (SFM) Credit Cooperative in the sum of _________________________________________(Php______________),
Months
Philippine currency, which is payable in __________________, hereinafter referred to as the DEBTOR

Co- maker
That I, _______________________________________________________ , of legal age, Filipino, and a resident of
address
_________________________________________________ guarantees the payment of the loan obtained by the DEBTOR, hereinafter
referred to as the CO-MAKER

I, as the CO-MAKER, hereby DECLARE that I SOLIDARILY LIABLE that in case the DEBTOR fails to pay the loan on
time, I am giving an IRREVOCABLE AUTHORIZATION for the Cooperative to immediately and automatically DEBIT the amount
of loan plus interest or any amount due from me in relation to above loan indebtedness, from my SHARE CAPITAL with the
Cooperative.

I hereby declare further that this declaration/irrevocable AUTHORIZATION shall bind the undersigned as well as all my
heirs and assigns.

IN WITNESS WHEREOF, I have hereunto set my hand this _____ day of ____________________ at Quezon City.

____________________________ _______________________________
Debtor Co-Maker

Signed in the presence of:

______________________ ________________________

REPUBLIC OF THE PHILIPPINES )


QUEZON CITY ) S.S.

BEFORE ME, this _____ day of ______________ at Quezon City, personally appeared:

_____________________________________
Co- maker Type of ID ID No#
with her ________________________________ known to me to be the
same person who executed the foregoing Declaration/Irrevocable Authorization and he acknowledged to me that the same is his free
and voluntary act and deed.

IN WITNESS WHEREOF, I have hereunto set my hand and seal on this _____ day of ________________ at Quezon City.

NOTARY PUBLIC

Doc. No. __________


Page No. __________
Book No. __________
Series of 2023

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