ACKNOWLEDGEMENT OF DEBT

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ACKNOWLEDGEMENT OF DEBT (SINGLE PAYMENT REQUIRED) Revenue Stamp Duty for each debtor I/We, the undersigned, _____________________________________________________________________________________ hereby acknowledge that I am/we are jointly and severally liable to _____________________________________________________________________________________ (hereinafter referred to as "the Creditor") in the sum of R ___________________ (hereinafter referred to as "the Capital") and I/we jointly and severally undertake to pay to the order of the Creditor the Capital together with interest at the rate of ______ % per annum from the ___________ day of __________________ year _________ to the _________________ day of __________________ year ______ subject to the following terms and conditions: 1. The full Capital together with the interest as aforesaid shall be due, owing and payable to the Creditor on the _________ day of ____________ year ________ at ________________________________________ free of bank charges and commission. 2. In the event of default, the undersigned shall be liable jointly and severally for all legal costs incurred in the collection of the outstanding balance on the scale as between attorney and own client including collection commission on Capital, interest and costs, plus interest at the rate of ________% per annum. Interest shall be calculated and capitalised on the same day of each month, in arrears, on the outstanding balance until the total amount due has been paid. 3. I/We hereby choose as my/our domicilium citandi et executandi for all purposes hereof, the following address/addresses: Name __________________________ Address ______________________________________________ Name __________________________ Address ______________________________________________ 4. The Creditor will be entitled to increase the interest rate from time to time to the maximum rate allowed by law. 5. I/We hereby consent to the jurisdiction of the Magistrate's Court having jurisdiction over my/our person/s in connection with all legal proceedings arising herefrom. 9.2a 6. I/We renounce the benefits of the legal exceptions non numeratae pecuniae, non causa debiti, error calculi, division and revision of accounts. I/We acknowledge that I am/we are fully aware of the meaning and effect of such renunciations. 7. The Creditor may cede or pledge its rights herein without the consent of the Debtor/s. 8. The Debtor/s may pay any portion of the Capital plus interest before the due date without derogating from any right he/she/they may have in terms hereof. 9. The Capital plus interest will become due and payable immediately on a provisional order of insolvency of the Debtor/s. SIGNED at ___________________________ this _______ day of _____________________ year ______. AS WITNESSES: 1. ___________________________ _______________________ DEBTOR _______________________ DEBTOR 2. ___________________________ 9.2b

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