DEED OF ACKNOWLEDGMENT OF DEBT

KNOW ALL MEN BY THESE PRESENTS:

I, JAY-R T. ABUAN, of legal age, Filipino, (single / married / widow), and a

resident of Blk 4 Lot 6 Phase 1 Dandelion St., Summerpointe Country Homes, Pasong
Buaya II, Imus, Cavite, after being duly sworn to in accordance with law, witnesseth and
declare:

That I am indebted in the sum of Four hundred fifty thousand pesos

(Php450,00.00), Philippine currency, to MARY GRACHELLE L. FLORES, who is
also of legal age, and a resident of 1139 Int. 54 Antipolo St. Tondo, Manila.

That I hereby promise and undertake to pay the said indebtedness unto the said
_____________ within a period of _____________ (_____) (months/years/days) from
today, in the amount of _____________ (P_____________) (monthly/daily) every
_____________ with interest at the rate of _____________ (_____%) per centum per
(month/annum) until fully paid.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ in

_____________, Philippines.

JAY-R T. ABUAN
Affiant

SIGNED IN THE PRESENCE OF:

_________________ __________________
 ACKNOWLEDGMENT

BEFORE ME, a Notary Public for and in the (Province/City/Municipality) of

_____________ this __date__ personally appeared _____________ with (government-
issued ID like LTO Driver’s license, PRC, Voter’s ID, SSS ID) ID No. ____________
issued on _____________ at _____________ known to me and to me known to
be the same person who executed the foregoing instrument, and he acknowledged to
me that the same is his free and voluntary act.

This Instrument consists of only ______ (____) page/s, including this page in which this
Acknowledgement is written, duly signed by _____________ and his instrumental
witnesses on each and every page hereof.

WITNESS MY HAND AND SEAL this _____________ at _____________,

Philippines.

NOTARY PUBLIC

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of ______;