JCS PETRON SERVICE STATION

Maharlika Highway, Sumacab Sur,

Cabanatuan City, Nueva Ecija

DATE GRANTED_________________

Simple Promissory Note

(For those customers buying gasoline and other fuel products on Credit)

For service/petroleum products receive, I/We jointly and severally promise to pay JCS PETRON
SERVICE STATION or order at its office at Maharlika Highway, Sumacab Sur, Cabanatuan City, Nueva Ecija
the amount of ___________________________________(PHP______________________, Philippine
Currency, in ___________________ installment(s) of PHP_______________ Starting at
________________________ until the whole obligation is fully paid at the rate of
________________(________%)percent with liquidated penalty on each unpaid installment at the rate of
__________ (________%) percent per month of default. We / I further agree to the following terms and
conditions:
1. That total credit limit of the service/petroleum products shall be up to maximum amount of
P_____________________ ;

2. That these credits are payable either by way of:

Weekly semi-monthly monthly ___ days after billing date ;

3. That payment shall be in the form of cash or dated check. In case of bouncing check, it shall be
charged an additional of 10% of the sales as penalty charge;

4. Other applicable condition/remedies.

1. In case of litigation, the venue shall be in Cabanatuan City;

2. Always observe maximum credit limit;
3. In case purchase exceeds credit limit, ask the approval of the manager.

_____________________________
Customer’s Signature

Conforme:

________________________
Manager

Signed in the presence of:

__________________________ _____________________________

ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES )
CITY OF CABANATUAN ) S.S.

BEFORE ME, a Notary Public for and in the City of Cabanatuan this _______day of
_____________, 2017, personally appeared the above-named persons known to me and to me known to be
the same persons who executed the foregoing instrument and acknowledged to me that the same are their
own free act and voluntary deed.

WITNESS MY HAND AND NOTARIAL SEAL.

DOC NO._________;
PAGE NO.________;
BOOK NO.________;
SERIES OF 2017;