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Employee Acknowledgement of Debt fill-in form (South Africa, English)
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Employee Acknowledgement of Debt
I, the undersigned, _________________________ hereby acknowledge and obligate as follows:
(Employee Name)
1. I am liable to _________________________ (the "Creditor") in the sum of R ______________ (the "Debt").
(Employer Name)
2. I undertake to pay to the order of the Creditor the Debt together with interest at the rate of ______ % per annum on __________, 20___, at ________________________________________ free of bank charges and commission.
3. In the event of default, I shall be liable for all legal costs incurred in the collection of the outstanding balance plus interest at the rate of ___________ % per annum. Interest shall be calculated and capitalized on the same day of each month, in arrears, on the outstanding balance until the Debt due has been fully paid.
4. I hereby choose as my domicilium et executandi for all purposes hereof, the following address: _______________________________________________.
5. I hereby consent to the jurisdiction of the Magistrate’s Court having jurisdiction in all legal proceedings arising from this letter.
SIGNED at ________________________________ on the __________, 20___.
______________________________
(Employee signature)
AS WITNESSES :
1.
2.
______________________________
(Creditor signature)
AS WITNESSES :
1.
2.