CHATTEL MORTGAGE

KNOW ALL MEN BY THESE PRESENTS:

That I, ______, Filipino, of legal age, single and a resident of ________ Philippines hereinafter
known as the MORTGAGOR, and ________, of legal age, married, Filipino and a naturalized American
citizen with postal address at ________________hereinafter known as the MORTGAGEE, witnessth:

That the MORTGAGOR is indebted unto the MORTGAGEE in the sum of FIFTY THOUSAND
PESOS (P50,000.00) Philippine Currency, receipt of which is acknowledged by the MORTGAGOR
upon the signing of this instrument, payable within a period of _____ years, with interest thereon at the
rate of 10% per annum.

That for, and consideration of, this indebtness, and to assure the performance of said obligation to
pay, the MORTGAGOR hereby conveys by way of CHATTEL MORTGAGE unto the MORTGAGEE,
his heirs and assigns, the following personality now in the possession of said MORTGAGOR.

MAKE : Mitsubishi MOTOR NO. : 4G1114

YEAR MODEL : 1987 CHASSIS NO. : AO5AXNMHL6
BODY TYPE : 4-door sedan PLATE NO. : GHF 939

That the condition of this obligation is that should the MORTGAGOR perform the obligation to
pay the hereinabvove cited indebtedness of FIFTY THOUSAND PESOS (P50,000.00) together with
accrued interest hereon, plus the actual value of any repair work related expenditures of the said vehicle
while in the possession of the MORTGAGEE, this chattel mortgage shall at once become null and void
and of no effect whatsoever, otherwise, it shall remain in full force and effect.

IN WITNESS WHEREOF, the parties have hereunto set their hands this_________day of_______2018
at Cebu City, Philippines.

___________________________ ________________________
MORTGAGOR MORTGAGEE

IN THE PRESENCE OF:

___________________________ ________________________

ACKNOWLEDGEMENT

Republic of the Philippines)

______________________) S.S.

BEFORE ME, personally appeared:

Name CTC Number Date/Place Issued

Known to me to be the same person who executed the foregoing instrument and acknowledged tome that
the same is their free and voluntary act and deed.

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

Doc. No.______
Page No.______
Book No.______
Series of 20____