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$___________________(1)_________ ______________(2)_____________
FOR VALUE RECEIVED, the undersigned, (jointly and severally, if more than one)
promises to pay to _____________(4)________________, of __________(5)_____________, or
order, in the manner hereinafter specified, the principal sum of _______(6)__________ Dollars
($________________) with interest from date at the rate of __________(7)_________ percent
(_____%) per annum on the balance from time to time remaining unpaid. The said principal and
interest shall be payable in lawful money of the United States of America at the address stated
above, or at such place as may hereafter be designated by written notice from the holder to the
maker hereof, on the date and in the manner following:
Principal and interest payments of $_____________(8)___________ each, due on or
before the ________(9)___________ day of each month, beginning _____________(10)
________, ____________(11)________, and continuing each month thereafter for a period of
_____________(12)____________ years.
Then on ______________(13)____________, simultaneously with the payment of the
____________(14)___________ monthly payment, the full amount of unpaid principal, plus
accumulated interest and any advances made, shall balloon and become immediately and fully
due and payable, without demand.
This note with interest is secured by a mortgage on real estate, of even date herewith,
made by the maker hereof in favor of the said payee, and shall be construed and enforced
according to the laws of the State of _____________(15)_______. The terms of said mortgage
are by this reference made a part hereof.
If default be made in the payment of any of the sums or interest mentioned herein or in
said mortgage, or in the performance of any of the agreements contained herein or in said
mortgage, then the entire principal sum and accrued interest shall at the option of the holder
hereof become at once due and collectible without notice, time being of the essence; and said
principal sum and accrued interest shall both bear interest from such time until paid at the highest
rate allowable under the laws of the State of _____________(16)________.
Failure to exercise this option shall not constitute a waiver of the right to exercise the
same in the event of any subsequent default.
Each person liable hereon whether maker or endorser, hereby waives presentment,
protest, notice, notice of protest and notice of dishonor and agrees to pay all costs, including a
reasonable attorney's fee, whether suit be brought or not, if, after maturity of this note or default
hereunder, or under said mortgage, counsel shall be employed to collect this note or to protect
the security of said mortgage.
Whenever used herein the terms "holder", "maker" and "payee" shall be construed in the
singular or plural as the context may require or admit.

The information in this document is designed to provide an outline that you can follow
when formulating business or personal plan. Due to the variances of many local, city, county and
state laws, we recommend that you seek professional legal counseling before entering into any
contract or agreement.