REPUBLIC OF THE PHILIPPINES

PROVINCE OF TARLAC……………..)
MUNICIPALITY OF PANIQUI……..)

AFFIDAVIT OF INDEPTEDNESS AND PROMISE TO PAY

I, DANILO D. DAGUIO, of legal age, married, Filipino citizen and a resident of Brgy. Acocolao,
Paniqui, Tarlac, after having been sworn in accordance with law, despose and say;

That I hereby acknowledge receipt as a loan the sum of P32,000.00 from Mr. JAIME L. ASUNCION,
Of legal age, widower, Filipino citizen and resident of Brgy. Cabayaoasan, Paniqui, Tarlac;

That hereby promise and bind myself, my heirs and assigns, to pay and deliver the said amount of
P32,000.00 unto said Mr. Asuncion, his heirs and assigns before June 30,2011 without monthly interest;

That if I fail to pay and deliver the said amount unto said Mr. Asuncion his heirs and assigns when it
falls due, then I shall be liable to him for all the expenses and damages, including attorney’s fees, should
He brings the case to court by reason of my refusal or failure to pay with 7% monthly interest;

IN WITNESS WHEREOF, I hereto affixed my signature this _______ day of __________ ,2011 at
Paniqui, Tarlac.

DANILO D. DAGUIO
Affiant

WITNESSES;

HERMINIA G. ZAMORA ALMA REBOLLEDO

SUBSCRIBED AND SWORN to before me this ____ day of__________, 2011 at Paniqui, Tarlac.

Doc.No. ________
Page No. _______
Book No. _______
Series of 2011
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PageNo._____
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Series o 2011