Town, Province/City

PROMISSORY NOTE/CO-MAKERS STATEMENT

PN No. _______________________________________ ___________________________________, Philippines

Date Granted: __________________________________ Maturity Date: ________________________________
Interest Rate: ____________________________ (__%)
Term/Period of Loan: ____________________________ Mode of Repayment: ___________________________ Amount of Installment:
__________________________
Date of installment: First Installment to fall due on _________________ and every _________________ thereafter until the whole sum of the principal
and interest shall have been fully paid. Penalty of _______________________ shall be imposed per day on the amount of installment due from date of
default until fully paid.
This Note is secured by: _________________________________________________________

FOR VALUE RECEIVED, I/WE jointly and severally promise to pay the RURAL BANK OF XYZ, INC. the sum of PhP
________________________________________________ (P______________).

I/WE hereby agree and authorize RURAL BANK OF XYZ, INC. to encumber, assign or sell to any person or entity any right which may
have under this Note and/or any assignment, mortgage lien, pledge or other encumbrances constituted in favor of RURAL BANK OF XYZ, INC.
pursuant to the provisions of the loan agreement and this Note, if any the consent herein granted is recognized and acknowledged by me/us as a
waiver, to all intents and purposes of whatever right I/we may have to notice of actual encumbrances or assignment.

Should a delay be made in the payment of an installment of at least __________ days, the whole sum remaining unpaid under this Note
shall forthwith become due and demandable without need of further demand. In such case, I/WE jointly and severally agree to pay an additional
amount equivalent to P_________ per day due and demandable as penalty and collection charges in the form of liquidated damages until fully paid
and ten percent (10%) thereof or P1,000.00 whichever is higher for attorneys fees whether actually incurred or not, exclusive of cost and
judicial/extrajudicial expenses.

Further, I/WE jointly and severally empower and authorize the RURAL BANK OF XYZ, INC. the option, and without notice, to set off or
apply to the payment of this Note any and all funds which may be in their hands on deposit or otherwise belonging to me or one or anyone of us which
may be in their possession or control by virtue of any other contract.

That I, the borrower, has attended a client orientation, and that I fully understand all the features of the product as well as the term and
conditions set forth in granting this loan.

DEMAND AND DISHONOR WAIVED. Holder may accept partial payment reserving his/her rights or recourse against each and all
endorsers.

VENUE OF ACTION. I/WE agree that any action arising in connection or by reason of this Note shall be filed exclusively with the courts in
XYZ, (Province) .

I/WE hereby affix my/our signature(s) at _________________________________________________, Philippines, on

___________________________________.

MAKER MAKER

Signature: _________________________________________ Signature: _____________________________________________

Name in Print: _____________________________________ Name in Print: __________________________________________

Address:_________________________________________ Address: ______________________________________________

________________________________________________ _____________________________________________________

I agree to become a co-maker to this Promissory Note. I am aware of the responsibility which I will assume in signing such a note.

CO-MAKER CO-MAKER

Signature:____________________________________________ Signature: ___________________________________________

Name in Print:_________________________________________ Name in Print: ________________________________________

Address: _____________________________________________ Address: _____________________________________________________

_____________________________________________________ _________________________________________________________

SIGNED IN THE PRESENCE OF:

____________________________ ______________________________
Name and Signature of Witness Name and Signature of Witness

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