September 14, 2017
September 14, 2017


  1. I, the undersigned _________________________________________ (hereinafter referred to as “the Debtor”) do hereby acknowledge myself to be truly and lawfully indebted to (hereinafter referred to as “the Creditor”) in the sum of R.


  1. I hereby undertake to repay the said sum of R together with interest at the rate of % (per annum) in monthly instalments of R per month commencing on the day of 20, and all subsequent instalments to be paid on or before the corresponding day of each and every succeeding month until the full amount has been repaid, subject to the following terms and conditions:


2.1        The full amount together with the interest as mentioned shall be due and payable to the Creditor on the day of , 20 at free of bank charges and commission.


2.2        In the event of default, I shall be liable jointly and severally for all legal costs incurred in the collection of the outstanding balance including attorney’s costs, 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 amount due has been paid.


2.3        I hereby choose as my domicilium et executandi for all purposes hereof, the following address at which address all notices and communications may be addressed and posted to me. All notices addressed and posted to me at the said address by prepaid registered post, shall be deemed to have reached me in the ordinary course of postal deliveries:



  1. The Creditor will be entitled to increase the interest rate from time to time to the maximum rate allowed by law.


  1. I hereby consent to the jurisdiction of the Magistrate’s Court having jurisdiction over me in connection with all legal proceedings arising here from.


  1. The Creditor may cede or pledge its rights herein without my consent.


  1. It is agreed that I may pay any portion of the amount plus interest before the due date without derogating from any right I may have in terms hereof.


  1. The amount plus interest will become due and payable immediately on a provisional order of insolvency on myself.


  1. I understand and agree that any acceptance of my undertaking by the Creditor shall not in any way prejudice any rights whatsoever that the Creditor may have against me and I further agree that, should I default as aforesaid, proceedings may be instituted or continued (as the case may be) against me.


  1. In terms of Section 45 of Act No. 32 of 1944, or any amendments thereof, I hereby consent to the Creditor taking any legal proceedings for any of its rights hereunder for recovery of the monies claimable hereunder or otherwise, if it so elects, in the Magistrate’s Court of any district having jurisdiction in respect of such proceedings against me by virtue of s 28 (1) of the Act.


  1. I acknowledge that the full balance outstanding from time to time in terms of this Acknowledgement of Debt shall bear interest at the rate of % () per annum on a reducing balance.


  1. I hereby agree that the repayments to be made by me, be reviewed every 6 (six) months with the view to increasing them should my financial position improve.





Signed at ________________________ on this ________ day of _______________ 20_____.




____________________________          __________________________

Debtor name                                           Debtor signature




As witnesses:








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