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Affidavit of Acknowledgement of Obligation With Undertaking To Pay Form

The affiant acknowledges a financial obligation of [AMOUNT] to Paglaum Multipurpose Cooperative as of [DATE]. The obligation is comprised of various loans with principal amounts, interest, and penalties. The affiant agrees to pay the grand total of [AMOUNT] under the terms of [PAYMENT TERMS]. Failure to pay according to the agreement may result in criminal, civil, or administrative actions against the affiant. The affiant understands and attests to the full explanation of the obligation.

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1K views

Affidavit of Acknowledgement of Obligation With Undertaking To Pay Form

The affiant acknowledges a financial obligation of [AMOUNT] to Paglaum Multipurpose Cooperative as of [DATE]. The obligation is comprised of various loans with principal amounts, interest, and penalties. The affiant agrees to pay the grand total of [AMOUNT] under the terms of [PAYMENT TERMS]. Failure to pay according to the agreement may result in criminal, civil, or administrative actions against the affiant. The affiant understands and attests to the full explanation of the obligation.

Uploaded by

Nam Legalis Justitia Bellator
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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REPUBLIC OF THE PHILIPPINES

)
CITY/MUNIPALITY OF __________________ ) Sc.
AFFIDAVIT OF ACKNOWLEDGEMENT OF LIABILITY/OBLIGATION WITH
UNDERTAKING TO PAY
I, ___________________________________, of legal age, single/married, Filipino
and a resident,_________________________,__________________ Misamis Occidental,
after having been duly sworn to in accordance with law, do hereby depose and state:
That I hereby acknowledged having financial obligation to PAGLAUM MULTIPURPOSE COOPERATIVE in the amount of PHP____________________, as of
_____________, computed as follows;
1.
2.
3.
4.
5.

Type of Loan
___________________
___________________
___________________
___________________
___________________

Amount
P_________
P_________
P_________
P_________
P_________

Total----------------------------P_________

Interest
P________
P________
P________
P________
P________

Penalties/other charges
P_______________
P_______________
P_______________
P_______________
P_______________

P________

P_______________

Grand Total Obligation----------P_________________________


That I hereby undertake to pay the above mentioned obligation under the following
terms and conditions:
(
(
(
(

) Monthly installment in the amount of ------------------- P_____________


) Daily installment in the amount of ----------------------- P_____________
) Quarterly installment in the amount of -------------------P_____________
) Others ____________________________________________________
__________________________________________________________
__________________________________________________________

That failure on my part to pay in accordance with the above mentioned agreement
will warrant the filing of Criminal/Civil/Administrative case against me;
I hereby attest that the above mentioned obligation was fully explained to me and I
understood all my obligations stated herein;
IN TRUTH WHEREOF, I have hereunto set my hand this __________________ at
______________________________.
__________________
Affiant/Obligor
ID No._______________________
Affiant is personally identified by:_________________ with ID______________
________________________
Conforme/Rep. of Paglaum
SUBSCRIBED AND SWORN to before me on the date and place first above-written.
NOTARY PUBLIC
Document No._________;
Page No._____________;
Book No._____________;
Series of 2014

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