I,_______________ (mortgagee) hereby acknowledge that the sum of mortgage money borrowed from__________(mortgagor) herein called as the creditor who stays at _______________,(address) lends a money of sum of Rs.___,. If at any causes if there is any default in the payment of the mortgage money then the creditor is having the full right to ask for the repayment of the mortgaged money with the interest in the arrears of ___% of the mortgaged money.

_____________
(signature)

_____________
(date)