Simple Promissory Note printable pdf download

Simple Promissory Note

Mic hael D Moore DDS

Simple Promissory Note & Financial Agreement

This Simple Promissory Note & Financial Agreement is made between (Your Office Name

Here) and,

__________________________________________

who agrees and promises to pay

(Your Office Name Here) the sum of $000.00 dollars for services received and as to the

following terms,

1. Pay balance owning in full by

2. Make a minimum monthly payment of $_____________ each month until the balance is

paid in full.

3. Pay an interest at the annual rate of

% payable after

4. If this agreement is in default and is placed for collection shall pay all reasonable costs

of collection and attorneys' fees.

By signing, I have read and agree to the above terms.

___________________________________________ Date _____________________

(Signature)

___________________________________________

(Social Security Number)

_____________________________________________________________________

(Address)

___________________________________________ Date______________________

(Representative of Your Office Name Here)

Simple Promissory Note