Payment Agreement

Date of Loan: {{date_of_loan}}

Due Date of Repayment: {{repayment_date}}

Total Amount Due: {{loan_amount}}

Terms of the Agreement:

I, {{borrower_name}}, borrowed $200 on October 16th, 2012, from {{lender_name}}. The money was borrowed in a loan to be repaid in a series of scheduled repayments. I, {{borrower_name}}, will repay the entire amount of the loan, $200, in a series of scheduled payments of $50 each. These payments will be made by personal check to {{lender_name}} on the repayment schedule listed below. The loan will be repaid in full by {{repayment_date}}. If for any reason any scheduled repayment is late, a $5 per day late charge will ensue until the entire amount of the scheduled repayment, with additional late fees, is paid.

Loan Repayment Schedule

Payment 1: [Date] - $Amount

Payment 2: [Date] - $Amount

Payment 3: [Date] - $Amount

Payment 4: [Date] - $Amount

Payment 5: [Date] - $Amount

Payment 6: [Date] - $Amount

Payment 7: [Date] - $Amount