Fill and Sign the Acknowledgement of Debt Form

Debt Acknowledgement (IOU) I, the undersigned _____________________ (Name of Debtor) hereby confirm and acknowledge to ______________________ (Name of Creditor), hereinafter called Creditor, that I am indebted to said Creditor in the amount of $ _______________dollars as of the date set forth below. The amount includes any and all legally permitted charges, such as accrued interest, up to the dated set forth below. I acknowledge and agree that I incurred said Debt and I am solely responsible for repayment of it to Creditor. I also agree and acknowledge that I have no defense should the Creditor use this document in a court of laws as a confession of judgment on my part (where legally permissible). I have promised and agreed to pay the entire amount by __________________ (date) , and I will pay a least $___________ of the amount of said Debt on or before the __________________ (date) of each month beginning ___________________ (date), until it is paid. I have agreed that the entire amount of said Debt will be paid on or before __________________ (date). I signed this document on the _________________ (date) in front of the Witness named below. ____________________________________ ___________________________________ Name & Signature of Witness Name & Signature of Debtor ___________________________ ____________________________ _______________________ ________________________ Address & Phone Number of Witness Address & Phone Number of Witness