PN Number _____________
KNOW ALL MEN BY THESE PRESENTS:
The I/We, ________________ member(s) of _______________, of legal age and residing at ___________________, Philippines in consideration of the sum of _____________________ (Php______) , my/our share capital/deposit with said cooperative/bank covered by Certificate of Share Capital No. _________ / Savings Account No. _________ issued to me/us and it is understood that said cooperative has full control of the said sum of ___________ (Php________) from and after this date, and that said amount cannot be withdrawn by the undersigned, our heirs and assignees, unless the loan granted to us by said Cooperative as well as the interest due thereon and expenses incurred have been full paid. In the event tat said loan of ______________ (Php________ ) is not paid at maturity date or at any season whatsoever, said Cooperative is fully authorized and empowered to apply the same as payment o the loan herein mentioned.
IN WITNESS WHEREOF I/WE have hereunto affixed our signature at ____________________________________ on this ___________ day of ___________________, _______.