CHATTEL MORTGAGE

This CHATTEL MORTGAGE, executed this _____ day of _________, ____ by NAME OF PERSON, a
Filipino, of legal age, single/married/widow/separated with residence at
__________________________________________ , as MORTGAGOR, in favor of ADVENTIST MEDICAL
CENTER INC.-VALENCIA CITY, a corporation duly organized and existing under the laws of the
Philippines, with residence located at
__________________________________________________________ represented in this instance by
_________________________, its duly authorized representative, as MORTGAGEE,

WITNESSETH, That:

1. The MORTGAGOR hereby hypothecates and conveys by way of mortgage to the MORTGAGEE
its successor and assigns, all of the following described personal property situated at
_____________________________________ and now in the possession of the MORTGAGOR, to wit:

HYUNDAI DROPSIDE

MODEL NO.:
CHASSIS NO:
ENGINE NO:
PLATE NO.:

Together the body build or that may be built thereon, all the equipment, attachments or accessories
which may now or from time to time be used in connection with or attached to the said property (ies)
above described, the claims whatsoever of any person or entity.
2. This mortgage is given as security for the performance of the following obligations and
especially for the payment and compliance by the MORTGAGOR of that certain promissory note, under
its terms and conditions, executed on the ____day of _____________, 2019 for the sum of
(P___________________) PESOS, a copy of which is hereto attached and herein incorporated by
reference and made a part hereof and further, as security for the payment of any total or partial
extension, replacement, restructuring or renewal of the said note Loan Agreement.
3. This sum of ____________________________________________________,
(P__________________) is payable in installments in accordance with the provisions of said Loan
Agreement which provisions are incorporated herein in this contract. That the amount of
__________________________________________________ (P_____________) payable on
__________________ . Penalty charge of Three Percent (3%) per month shall be charge on the overdue
payment.
4. Should the MORTGAGOR (s) make other purchases on credit or otherwise become indebted
to the MORTGAGEE, in additional sums of money under any concept whatsoever, then such sums shall
be added to the principal sum of which this mortgage is given as security and shall be payable in the
manner stipulated in the corresponding invoice or instrument and shall bear interest at the rate therein
provided, and said additional indebtedness shall become part of the sum herein secured and shall
likewise be guaranteed by this mortgage.
5. The MORTGAGOR (s) hereby warrant(s), acknowledges (s) and accept(s) that his/her/their
property (ies) covered by this mortgage is in good order and running condition and hereby undertake(s)
and obligate(s) himself/herself/themselves to use with extraordinary care or diligence, preserve and
maintain the said property in good order and running condition during the existence of this mortgage
and further shall not remove or change any accessories therein or change the painting therein without
the written conformity of the authorized representative of the MORTGAGEE and furthermore allow the
MORTGAGEE of its authorized representative of the MORTGAGEE to inspect the property at any time.
Failure on the part of the MORTGAGOR(s) to follow these conditions shall be construed as a violation of
the mortgage contract.
6. The MORTGAGOR (s) shall not have any repair made on the mortgaged property without the
written content of the MORTGAGEE, and notice is hereby given to all the world that the MORTGAGEE
shall not recognize and will not be responsible for, nor shall said mortgaged property nor any part
thereof, be held under any lien for any indebtedness whatsoever, except the indebtedness hereby
secured.
7. The MORTGAGOR(s) furthermore hereby bind(s) himself (themselves) not to sell, mortgage or
otherwise disposed of the mortgaged property or any portion thereof without consent in writing of the
MORTGAGEE first obtained.
8. MORTGAGOR(s) represent(s) and bind(s) himself (themselves) to use the unit only for his
(their) private or personal needs and that the motor vehicle afore described will never be used as a
public utility vehicle or taxi unless proper representation has been made by the MORTGAGOR to the
MORTGAGEE its successors and assigns, for the motor vehicle afore described to be used as public
utility or taxi, for which the MORTGAGEE its successors and assigns, has (have) signified its approval in
writing.
9. The MORTGAGOR further covenant and agree that in case proper endorsement in favor of the
MORTGAGEE has not been made yet in the insurance policy and loss or damage occur, the MORTGAGEE
warrants that he/she will inform to the insurance company that any claim therein will be payable to the
MORTGAGEE by the insurance company and not to claim the damage proceeds therein for his/her
benefit or other persons. However, in the event the MORTGAGOR (s) contravene (s) the terms and
conditions previously set forth under paragraph 5,7 and 8 of this mortgage contract, any loss or damage
to the mortgage property shall be deemed exclusively payable to the MORTGAGEE and the
MORTGAGOR(s) agree(s) that proper endorsement shall be deemed to have also been made in favor of
the MORTGAGEE.
The said MORTGAGOR covenants and agrees that he/it will cause the properties hereinabove
mortgaged to be insured against loss or damage by accident, theft and fire for a period of one year from
date hereof and every year thereafter until the mortgage obligation is fully paid with an insurance
company acceptable to the MORTGAGEE in an amount not less than the outstanding balance of the
mortgage obligation; that he/it will make all loss, if any under such policy or policies payable to the
MORTGAGEE or its assigns as its interest may appear and deliver such policy or policies to the
MORTGAGEE forthwith.

10. The MORTGAGOR agrees to execute and deliver the MORTGAGEE such further documents as
may from time to time be required by the MORTGAGEE to give full force and validity to this mortagage;
and to furnish all documentary stamps necessary for this transaction and to pay all fees and expenses
for the execution, registration and cancellation for this document and of all other documents executed
in connection therewith.
11. The MORTGAGOR agrees that the MORTGAGEE, at its sole option and discretion, may, at any
time, or from time to time, (a) extend or change the time, manner, place or terms of payment (b)accept
additional and/or substitute collaterals, exchange, release or surrender all or any of the security, or nay
part thereof, by whomsoever offered or executed, which is now or may hereafter be held by the
MORTGAGEE, and (c) settle or compromise with the MORTGAGOR, or any other person, firm or
corporation liable hereon any or all of the subordinate the payment or any part thereof, to the payment
of any other debts or claims which may at any time be due or owing to the MORTGAGEE or any other
person or corporation; all in such manner and of such terms as the MORTGAGEE may deem proper, and
without notice to or further assent from the MORTGAGOR.
12. In case the MORTGAGOR fails to pay any of the installments as and when the same fails due
at hereinabove provided, or otherwise violates any of the terms and conditions of this agreement, then
the MORTGAGEE shall have the right, at option, to declare the entire amount of all the obligations due
and payable, and may, likewise at its option, either foreclose this mortgage or file an ordinary civil action
for the collection of said indebtedness.
13. In cases of breach or default by the MORTGAGOR of any condition of this agreement and in
the event of the foreclosure of this mortgage, or in the event any action is filed by the MORTGAGEE
under this instrument, the MORTGAGOR expressly agrees to pay to the MORTGAGEE an additional sum
equivalent to twenty five (25%) percent of the amount due and unpaid as attorney’s fees, which shall
not be less than Php 1,000.00, plus the costs of collection and legal costs, and in addition a further sum
as liquidated penalty computed at 3% per month of default, which said sums shall be added to the
principal sum of which this mortgage is given as security and shall become a part thereof and deemed
secured by this mortgage.
14. Should the mortgage property be lost, destroyed, or damaged from any cause whatsoever,
the MORTGAGEE shall immediately have the right to declare the whole amount of the indebtedness
secured hereby due and payable, and may proceed at once as herein provided, either to foreclose this
mortgage or file an ordinary civil action for the collection of the entire indebtedness including in both
cases the liquidated damages and the attorney’s fees above mentioned; if the MORTGAGOR shall
immediately after the loss, destruction, or damage of the said mortgaged property as aforesaid, give
additional security to the satisfaction and approval by the MORTGAGEE, to cover the balance of the
amount which may at any time be owed to the MORTGAGEE under this mortgage then and in that case
the MORTGAGEE may grant a reasonable extension of time to the MORTGAGOR for the payment of the
amount secured by this mortgage. The said property shall be considered as lost, to all intents and
purposes, if the MORTGAGOR shall fail to produce the same or any part thereof, on demand by the
MORTGAGEE. In such case, the same shall be considered an admission and confession by the
MORTGAGOR that he has removed, sold or pledged the property mortgaged in violation of Article 319 of
the Rules of Court.
15. In the event any insolvency proceedings are filed by or against the MORTGAGEE or any of
them or in the event any petition for suspension of payment is instituted by him (them), or in the event
any attachment is levied upon his (their) properties or any of them at the instance of any creditor, the
MORTGAGEE shall have the right, at its option, to declare the obligations herein guaranteed
immediately due and demandable and may thereupon foreclose this mortgage obligation.
16. At any time after the breach or default in the performance of any condition herein stipulated
more particularly his (their) failure to pay any installment as above provided or to pay when due, any
other obligation which said MORTGAGOR may incurred, or upon the occurrence of any of the
contingencies provided for in the preceding paragraphs, the MORTGAGEE may foreclose this mortgage
immediately before the expiration of thirty (30) days from date of default MORTGAGOR by these
presents waiving and renouncing expressly in advance whatever right they have or may have to any
term, right or privilege granted to him(them) by the Chattel Mortgage Law (Act 1608) or any other which
may be enacted in the future.
It is further agreed that in case of the sale at public auction under foreclosure proceeding of the
properties herein mortgaged or any part thereof, the MORTGAGEE shall be entitled to bid for properties
so sold or for any part thereof, to buy the same, or any part thereof, and to have the amount of its bid
applied to the payment of this obligations secured by this mortgage without requiring payment in cash
of the amount such bid.
17. The MORTGAGOR for all purposes of this mortgage and for the foreclosure of the same
hereby fixes his residence at the place hereinabove indicated without regard to the actual residence of
the MORTGAGOR or the place where the mortgaged property may be found. In any case of default on
the part of the MORTGAGOR , the latter shall, on demand of the MORTGAGEE, deliver said property to
said MORTGAGEE, in the same condition as when received (Ordinary wear and tear expected) in
mortgagee’s Address given above or other address indicated in the demand free of all charges; and
should the MORTGAGOR not deliver the said property as aforesaid, the MORTGAGEE is hereby
authorized to enter the premises where the property is located and take possession of the said property
wherever it may be found, and have the same brought to its office as given above or in any city or
municipality where the MORTGAGEE may have an office, at the option of the MORTGAGEE ,and the
expenses of locating and bringing the said property as well as damages which, the mortgaged property
may have suffered (ordinary wear and tear expected ) shall be for the account of the MORTGAGOR and
form part of the sum secured by this mortgage: PROVIDED, however, that the MORTGAGEE shall have
the option of selling the said property at any place where the same may be found or in the addresses or
places hereinabove provided. The MORTGAGOR hereby waiving all rights to any notice of such sale, as
well as to any and all actions on claims against MORTGAGEE that may arise from the latters’s taking
possession of the property.
18. The MORTGAGOR hereby waives all benefits to which he may be entitled under Article 1252
of the New Civil Code, and the MORTGAGEE at its option, may apply the payments made by the
MORTGAGOR to any of his obligations to the MORTGAGEE covered by this mortgage.
19. It is hereby agreed that any and all questions arising under the Chattel Mortgage shall be
exclusively submitted to a court, at the competent jurisdiction of Cagayan De Oro City or at the option of
the mortgagee. The term MORTGAGEE includes his assigns and the successors in interest.
20. The obligation hereby undertaken, if made by more than one MORTGAGOR, is joint and
several.
21. If any condition of this mortgage is held invalid or contrary to law, the validity of the other
conditions of this mortgage shall not be affected thereby.
22. The conditions of this mortgage are such that if the MORTGAGOR, his heirs, executors or
administrators shall well and truly perform the full obligations above stated according to the terms
thereof, then this mortgage shall be null and void; otherwise it shall remain in full force and effect.

Executed at the Valencia City, Philippines, this _____ day of ____________ ,20 ____
With marital conformity:

_____________________ ________________________
SPOUSE MORTGAGOR

SIGNED IN THE PRESENCE OF:

_____________________ ________________________

AFFIDAVIT OF GOOD FAITH

We, severally swear that the foregoing mortgage is made for the purpose of
securing the obligations specified conditions thereof and that the same is a just and valid
obligation, and one not entered into the for the purpose of fraud.

___________________________ _______________________________
MORTGAGEE MORTGAGOR

CERTIFICATE OF OATH AND ACKNOWLEDGEMENT

REPUBLIC OF THE PHILLIPINES)
VALENCIA CITY )S.S.

BEFORE ME, a notary public in and for the City of Valencia and Province of Bukidnon,
Philippines, this _______ day of ______________________________, 20 ____ personally appeared:

NAME I.D NO. VALID UNTILL

_________________________ __________________________ _____________________

_________________________ __________________________ _____________________

_________________________ __________________________ _____________________
known to me and to me known to be the same persons who executed the foregoing chattel
mortgage consisting of three (3) pages including this page of Acknowledgment, which they
acknowledged as their free act and voluntary deed and that of the entities they represent, and they
made oath to the truth of the foregoing affidavit of good faith.

IN WITNESS WHEREOF, I have hereunto set my hand and affix my notarial seal at the place
and date hereinabove written.

Doc. No.:________;
Page No.:________;
Book No.:_______;
Series of 2019.
 PROMISSORY NOTE

For value and services received, I promised to pay, jointly and severally to Adventist Medical
Center Inc. – Valencia City or order at this office at Valencia City, the sum of TWENTY SEVEN THOUSAND
TWO HUNDRED THIRTY THREE PESOS AND EIGHTY ONE CENTAVOS (Php 19,931.66) payable on or before
June 9, 2019 with interest thereon at a fixed rate of three (3%) per month.

1. At the option of Adventist Medical Center-Valencia City, interest due on this notice which is
unpaid on due date shall be added to the principal and it shall be subject to the same rate and penalties
as the principal.

2. Time is declared of the essence and upon default of payment as scheduled, the entire
obligation shall automatically be due and demandable together with the following interest;

3. In case of default in payment, I shall pay ten (10%) percent of the principal of the total unpaid
obligation as penalty plus costs and expenses of the collection, provided however, that in any case it is
necessary to collect this note through an attorney, I shall pay thirty (30%) of the amount due and unpaid
obligation as attorney’s fees, provided further that the same shall not be less than P 1,000.00.

4. The outstanding obligation shall be subject as well to a fixed amount of eight (8%) percent
service charge notwithstanding of any agreed terms of payment other than the interest stipulated in the
note.

5. The extension of the term of the obligation shall not be presumed to be an automatic
extension of the period of the obligation in the absence of any express stipulation. In the event of non-
payment of the obligation and/or the interest and penalty charges applicable, the total amount
outstanding shall continue to bear interest and penalty charges as herein above indicated.

6. I/we furthermore declare that any action which may arise out of or in connection with this
note shall be instituted exclusively in Valencia City, before any court of competent jurisdiction, to the
exclusion of other courts.

Valencia City, May 10, 2019.

NORMELITA T. NACION EUGENIO BASILISCO NACION

Maker Co-Maker
Address: P-Kalayaan, Banisilan Poblacion, Philippines Address: Banisilan Poblacion, North
Cotabato
Tel no. _________________ Tel. No. _________________________
Voter’s ID: VIN: 4716-0003A-B0568NTN20000-3 Voter’s ID: VIN4716-0003A-
H2667EBN10000-7

Signed in the presence of:

__________________________________
____________________________________
Witness witness
ACKNOWLEDGMENT
REPUBLIC OF THE PHILIPPINES)
CITY OF VALENCIA )S.C.

BEFORE ME, A notary public for and in the city of Valencia personally appeared Normelita T.
Nacion and Eugenio Basilisco Nacion with their respective valid identification cards provided above as
competent proof of their identity, known to me personally to be the same persons who executed the
foregoing instrument and they acknowledged that the same is their free and voluntary act and deed.
WITNESS MY HAND AND SEAL this ___________________at Valencia City, Bukidnon,
Philippines.

Doc. No.____;
Page No. ___;
Book No. IV;
Series of 2019.