SOCIALIST REPUBLIC OF VIET NAM Independence – Freedom – Happiness No: 04C/CV ACKNOWLEDGEMENT OF DEBIT (Used in case of releasing loan from two or more times) Based on the Loan Contract No: Date Month Year 200 Signed between Branch of AGRIBANK in and Today, Date Month Year 200 at Branch of AGRIBANK in Borrower’s Full Name: Mr./Ms: Position: ID No: Issued Date: Issued by: Under Authorization (If any) No Date Month Year 200 Credit limit Debt Oustanding prior to this loan receiving: Amount of money requested to borrow (In numbers): (In words): Total debt oustanding remains: Loan purposes: - - - Maturity Interest Rate: %/year, Over-due Interest Rate: %/year. BORROWER BRANCH OF AGRIBANK IN (Signature and full name) CÁN BỘ TÍN DỤNG TRƯỞNG PHÒNG TÍN DỤNG GIÁM ĐỐC (Signature and full name) (Signature and full name) (Signature and full name) . the Loan Contract No: Date Month Year 200 Signed between Branch of AGRIBANK in and Today, Date Month Year 200 at Branch of AGRIBANK in Borrower’s Full Name: Mr./Ms: Position: ID No: Issued. purposes: - - - Maturity Interest Rate: %/year, Over-due Interest Rate: %/year. BORROWER BRANCH OF AGRIBANK IN (Signature and full name) CÁN BỘ TÍN DỤNG TRƯỞNG PHÒNG TÍN DỤNG GIÁM ĐỐC (Signature