Amount: Date:
Place:

I,______________(Name), make commitment to pay _______(Name of the company), the sum of Rs. ________. Repayment is to be made in the form of equal payments at the interest rate of ___ of Rs.___ payable on the 1st of each month, beginning from________ until the total amount of debt is paid.

In Witness whereof, I set my hand under seal this ____ day of_____ 20__ and I acknowledge receipt of a completed copy of this instrument.

(Signature of borrower)