Promissory Note

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DATE: Sept. 13, 2012, 4:25 p.m.

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  1. ----------------------------------------------------------------------------
  2. | |
  3. | Promissory Note |
  4. | |
  5. ----------------------------------------------------------------------------
  8. ----------------------------------------------------------------------------
  9. -------------------------- BORROWER INFORMATION ----------------------------
  10. ----------------------------------------------------------------------------
  12. Name:
  13. Street Address:
  14. ZIP / City:
  15. Country / State:
  16. Date of Birth:
  17. Loan Amount:
  18. Area code / Telephone number:
  19. Email Address:
  20. #bitcoin-otc Username:
  21. Driver's License Number:
  22. Social Security Number:
  23. PGP-Key ID:
  24. PGP-Key Fingerprint:
  25. Bitcoin Address:
  27. ----------------------------------------------------------------------------
  28. ---------------------------- LENDER INFORMATION ----------------------------
  29. ----------------------------------------------------------------------------
  31. Name:
  32. Street Address:
  33. City:
  34. ZIP:
  35. State:
  36. Country:
  37. Area code/Telephone number:
  38. Email Address:
  39. #bitcoin-otc Username:
  40. PGP-Key ID:
  41. PGP-Key Fingerprint:
  42. Bitcoin Address:
  44. ----------------------------------------------------------------------------
  45. ---------------------------- LOAN INFORMATION ------------------------------
  46. ----------------------------------------------------------------------------
  48. Loan Amount:
  49. Loan Period:
  50. Interest Rate:
  51. Payment Schedule:
  53. Bitcoin is a digital currency recognized by individuals and entities all
  54. over the world, hereafter referred to as "BTC".
  56. ----------------------------------------------------------------------------
  57. ------------------------ TERMS AND CONDITIONS ------------------------------
  58. ----------------------------------------------------------------------------
  60. 1.Promise to pay
  61. ----------------
  62. For value received, _____________________ (Borrower) promises to pay
  63. _____________________ (Lender) ____.________ BTC and interest at the
  64. rate of _.__% per
  65. [ ] day
  66. [ ] week
  67. [ ] month
  68. on the unpaid balance as specified below.
  71. 2.Installments
  72. --------------
  73. [ ] Borrower will pay ___.________ BTC each at
  74. [ ] daily
  75. [ ] weekly
  76. [ ] monthly
  77. intervals.
  79. [ ] Borrower will pay one lump payment on __/__/____ date (00:00:00 UTC).
  81. [ ] Borrower will pay ___ payments of ___.________ BTC each at
  82. [ ] daily
  83. [ ] weekly
  84. [ ] monthly
  85. intervals with a final baloon payment of ___.________ BTC at the end
  86. of the loan term on __/__/_____ date (00:00:00 UTC).
  89. 3.Application of payments
  90. -------------------------
  91. Payments will be applied first to interest and then to principal.
  94. 4.Prepayment
  95. ------------
  96. Borrower may prepay all or any part of the principal without penalty.
  99. 5.Late Payment Fees
  100. -------------------
  101. If Borrower defaults in payment by more than 3 days of the time set forth
  102. herein, then Borrower shall pay an additional late fee in the amount
  103. of 1.75% per day.
  106. 6.Loan Acceleration
  107. -------------------
  108. If Borrower is more than 14 days late in making any payment, Lender may
  109. declare that the entire balance of unpaid principal is due immediately,
  110. together with interest that has accrued.
  113. 7. Security
  114. -----------
  115. [ ] This is an unsecured note.
  116. [ ] Borrower agrees that until the principal and interest owed under this
  117. promissory note are paid in full, this note will be secured by the
  118. [ ] mortgage
  119. [ ] deed of trust
  120. covering the real estate commonly known as ________________________.
  121. [ ] Borrower agrees that until the principal and interest owed under this
  122. promissory note are paid in full, this note will be secured by the
  123. securities described below:
  125. ____________________________________________________________________________
  126. ____________________________________________________________________________
  127. ____________________________________________________________________________
  130. 8.Collection Costs
  131. ------------------
  132. The undersigned and all other parties to this note, whether as endorsers,
  133. guarantors or sureties, agree to remain fully bound until this note shall
  134. be fully paid and waive demand, presentment and protest and all notices
  135. hereto and further agree to remain bound notwithstanding any extension,
  136. modification, waiver, or other indulgence or discharge or release of any
  137. obligor hereunder or exchange, substitution, or release of any collateral
  138. granted as security for this note. No modification or indulgence by any
  139. holder hereof shall be binding unless in writing; and any indulgence on any
  140. one occasion shall not be an indulgence for any other or future occasion.
  141. Any modification or change in terms, hereunder granted by any holder hereof,
  142. shall be valid and binding upon each of the undersigned, notwithstanding the
  143. acknowledgement of any of the undersigned, and each of the undersigned does
  144. hereby irrevocably grant to each of the others a power of attorney to enter
  145. into any such modification on their behalf. The rights of any holder hereof
  146. shall be cumulative and not necessarily successive. This note shall take
  147. effect as a sealed instrument and shall be construed, governed and enforced
  148. in accordance with the laws of the ___________________ (State/Country).
  151. 9.Special Conditions
  152. --------------------
  153. ____________________________________________________________________________
  154. ____________________________________________________________________________
  155. ____________________________________________________________________________
  156. ____________________________________________________________________________
  157. ____________________________________________________________________________
  158. ____________________________________________________________________________
  159. ____________________________________________________________________________
  160. ____________________________________________________________________________
  161. ____________________________________________________________________________
  162. ____________________________________________________________________________
  163. ____________________________________________________________________________
  164. ____________________________________________________________________________
  165. ____________________________________________________________________________
  166. ____________________________________________________________________________
  167. ____________________________________________________________________________
  170. ----------------------------------------------------------------------------
  171. | THIS MESSAGE MUST BE SIGNED BY BOTH PARTIES - BORROWER AND LENDER. |
  172. ----------------------------------------------------------------------------
  174. --chmod755
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