I, B, son of A, resident of …………………………acknowledge to have received this day
the sum of Rs . ……………… (Rupees………..only) from X, son of Y, resident
of………………………… on account of the consideration of the promissory note executed by me
in favour of the said Shri Y.
Dated the………………………… day of…………………………20………..
B (Stamp)
(Signature across the stamp)

WITNESSES
1.
2.