Unique ID

Acknowledgement of Debt

ACKNOWLEDGEMENT OF DEBT

R0.00

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EFFECTIVE DATE

When will this Acknowledgement of Debt Contract become effective?*

On a specific date

When the agreement is signed by both parties

Leave a blank space on the final document

What is the specific date the Agreement becomes effective?*

CREDITOR

Who is OWED the money?*

This is the person or legal entity that needs to receive payment from the Debtor

A person

A Company

PERSON'S DETAILS

Enter the details of the Creditor.

Name*

Identity or Passport Number

Can be left blank ... a blank line will be provided in the final document.

Address

Can be left blank ... a blank line will be provided in the final document.

COMPANY DETAILS

Enter the details of the Creditor and the the person who will sign the agreement on behalf of the Creditor.

Company Name*

Company Registration Number

Can be left blank ... a blank line will be provided in the final document.

Company address

Can be left blank ... a blank line will be provided in the final document.

Representative's Name

Can be left blank ... a blank line will be provided in the final document.

DEBTOR

Who OWES the money?*

This is the person or legal entity that is going to pay the Creditor back.

A person

A Company

PERSON'S DETAILS

Enter the details of the Debtor.

Name*

Identity or Passport Number

Can be left blank ... a blank line will be provided in the final document.

Address

Can be left blank ... a blank line will be provided in the final document.

COMPANY DETAILS

Enter the details of the Debtor and the person who will sign the agreement on behalf of the Debtor.

Company Name*

Company Registration Number

Can be left blank ... a blank line will be provided in the final document.

Company address

Can be left blank ... a blank line will be provided in the final document.

Representative's Name

Can be left blank ... a blank line will be provided in the final document.

CONTACT DETAILS

Email Address*

Where we can send your Acknowledgement of Debt contract and where we can communicate with you.

Enter Email Confirm Email

Cell Phone Number

Please provide a valid cell phone number so we can send you updates regarding your purchase.

REASON FOR DEBT

How did the Debt arise?

Use complete sentences. You may leave this blank ... blank lines will be provided in the final document.

DEBT AMOUNT

How much money is still owed?

Include all amounts owing at the time this Acknowledgement of debt will come into effect (including the capital and any interest, costs, etc.). Can be left blank ... a blank line will be provided in the final document.

Please enter this amount in words too

Can be left blank ... a blank line will be provided in the final document.

Do you want to add a breakdown / schedule of how the Debt is Calculated?

Select "Yes" if you want to add additional information to the Acknowledgement of Debt as an annexure at the end of the document. You will need to compile this information yourself and add it to the end of the document.

Yes

No

This field is hidden when viewing the form

Do you want to upload the breakdown / schedule now or add it yourself later?

Upload now (the document you upload will be attached to the final Acknowledgement of Debt)

Add it later (the Acknowledgement of Debt will refer to an annexure but you will need to attached to document yourself)

INTEREST

Will interest be paid on the amount you entered above?*

Yes

No

Select "Yes" if the Debtor will pay interest on the amount in this Acknowledgement of Debt. The interest will be calculated from the date the Acknowledgement of Debt becomes effective. You can also select yes to add this clause and then cross it out later if the parties do not agree on the terms of the interest.

What percent (%) will be charge per year (per annum)?

Can be left blank ... a blank line will be provided in the final document.

PAYMENT METHOD

Where must payment be made?*

Choose the most appropriate option. Select "Other" if you are unsure. The final Acknowledgement of Debt document makes provision for the Creditor to change their preferred payment method if they wish.

Cash

Electronic Fund Transfer (EFT)

Debit Order (this option has an additional cost. A Debit Order Consent Form with also be created for the Debitor to sign)

Other

Where must payment be made?*

Choose the most appropriate option. Select "Other" if you are unsure. The final Acknowledgement of Debt document makes provision for the Creditor to change their preferred payment method if they wish.

Cash

Electronic Fund Transfer (EFT)

Other

Other payment method

Please complete the following sentence: "Payment must be made ...". Can be left blank ... a blank line will be provided in the final document.

DEBIT ORDER CONSENT DETAILS

Debit Order Consent

iLawyer will Create a Debit Order Consent document from the information you have provided in this questionnaire; the Debtor must add their bank account details to the final document and sign it. You can also choose to make a Debit Order Consent document separately with iLawyer, however, the cost is greater when making the document separately. iLawyer's separate Debit Order Consent document can be found in our website menu under "Documents". The signed Debit Order Consent must be presented to the Debtor's bank who will affect the Debit Order if the Debtor is eligible for the service; it is up to the Debtor's Bank to accept the Debit Order, iLawyer is not aware of a specific banks requirement and cannot ensure the Debit Order is implemented.

Price:

Total with Debit Order Consent document

Add the bank account details where payment must be made.

There is no need to add the details here; this can be left blank ... blank lines will be provided in the final document.

Add the bank account details where the Debit Order will be paid.

There is no need to add the details here; this can be left blank ... blank lines will be provided in the final document.

FULL AND FINAL SETTLEMENT

Will the Acknowledgement of Debt end all claims by the Creditor against the Debtor?

Select "Yes" if this agreement is in Final and Final Settlement of all claims between the creditor and Debtor regarding this Debt. This is only applicable if the Debtor complies with the terms of the Acknowledgement of Debt.

Yes

No

ACKNOWLEDGEMENT OF DEBT AS ORDER OF COURT

Do you want to add a clause that the Acknowledgement of Debt may be made an Order of Court?

Select "Yes" if the Debtor is to consent to this agreement being made an Order of Court. To make the document an Order of Court the Creditor will need to apply to the appropriate Court and ask that the signed agreement is made an Order of Court (an attorney will likely need to be hired for the application). The cost of this application will be for the Creditor. There is no obligation on the Creditor to apply to Court if they choose not to; the Acknowledgement of Debt will still be enforceable if they do not. This is not the same as a Judgment and there is no adverse effect on the Debtor provided they honour the terms of the Acknowledgement of Debt. If the Debtor does not honour the agreement the Creditor will be able to immediately execute the Court Order, through the appropriate Sheriff, as if it were a Judgement.

Yes

No

Do you want to quickly review your answers now?

Yes

No

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Terms and Conditions*

I agree to the Terms and Conditions

EFFECTIVE DATE

CREDITOR

PERSON'S DETAILS

COMPANY DETAILS

DEBTOR

PERSON'S DETAILS

COMPANY DETAILS

CONTACT DETAILS

REASON FOR DEBT

DEBT AMOUNT

INTEREST

REPAYMENT OF THE DEBT

SINGLE PAYMENT DETAILS

MULTIPLE INSTALMENT PAYMENT DETAILS

FIRST PAYMENT

SECOND PAYMENT

EQUAL PAYMENTS

CREATE YOUR OWN SCHEDULE OF PAYMENTS

PAYMENT METHOD

DEBIT ORDER CONSENT DETAILS

FULL AND FINAL SETTLEMENT

ACKNOWLEDGEMENT OF DEBT AS ORDER OF COURT

Acknowledgement of Debt