
 
LPB 28A-05 
Page 1 of 4 
PROMISSORY NOTE 
 
 
$       
  Date 
 
___________________________________________ 
  City, State 
 
FOR VALUE RECEIVED,    
  , 
hereinafter “Maker” promises to pay to    
  , 
hereinafter “Holder” or order at    
  , 
or other such place as may be designated by the Holder from time to time, the principal sum of    
   
Dollars  ($__________________), with interest thereon from _______ day of _____________________________ 
 
on the unpaid principal at the rate of    
 
percent  (__________%)  per annum as follows: 
 
1.  INSTALLMENT PAYMENTS: Maker shall pay,   (check one) 
 
  a.  (   ) NO INSTALLMENTS.  No installment payments are required. 
 
  b.  (   ) PRINCIPAL and INTEREST INSTALLMENTS of    
 
  ________________________________________________________ Dollars  ($  ). 
 
  c.  (   ) INTEREST ONLY PAYMENTS on the outstanding principal balance. 
 
(The following must be completed if “b” or “c” is checked) 
 
The installment payments shall begin on the _________ day of _____________________________________, 
and shall continue on the ____________________ day of each succeeding:    (check one) 
  (   ) calendar month       (   )  third calendar month     (   )  sixth calendar month     (   )  twelfth calendar month 
(   )  Other:_______________________________________________________________________________