Date:__________
I (Name)________, S/o. Sh.________ acknowledges that a sum of Rs.________ (In words) are due from me on the basis of account settled between me and (Name)______ . I, bind myself to pay of this sum by (Date)_______.
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(Signature)
I (Name)________, S/o. Sh.________ acknowledges that a sum of Rs.________ (In words) are due from me on the basis of account settled between me and (Name)______ . I, bind myself to pay of this sum by (Date)_______.
____________
(Signature)