Promissory Note - Ofw Watch
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1Republic of the Philippines
SOCIAL SECURITY SYSTEM
"Insert Branch Name"
"Insert Branch Address"
MBL- (03-2012)
PROMISSORY NOTE
SSS Member Loan Penalty Condonation Program for Individual Members
Date: ______________________
TO THE SOCIAL SECURITY SYSTEM:
_________________________________________________
(name
of
the
member)
with
SS
No.
___________________
and
residential
address
at
__________________________________________________________________,
promises
to
pay
the
Social
Security
System
the
amount
of
___________________________________________________________
(P______________)
in __________ (
) months, representing the monthly
amortization per attached installment payment schedule and to pay said amount either
to any SSS branch with tellering facility or SSS accredited bank.
Further, failure to pay the monthly amortization of my restructured loan on its due
date by at least two months shall render my account in default and shall terminate my
approved installment plan, cause re-imposition of accrued penalties on my loan in
proportionate amount, make my entire loan due and demandable, result in the
deduction of the total obligation from my future benefits, and cause permanent
suspension of my loan privileges.
______________________
Signature over printed name
SIGNED IN THE PRESENCE OF:
____________________________
__________________________
SUBSCRIBED AND SWORN to before me, a Notary Public for and in
____________ this __________________ at ________________, affiant exhibited to
me his/her Community Tax Certificate No. ___________ issued at ________________
on ___________________.
Doc. No. _______;
Page No. _______;
Book No. _______;
Series of _______;
______________________________________________________________________
______
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