SURAT PERNYATAAN

Yang bertanda tangan dibawah ini,

Nama : ......................................................................................
Tempat, Tgl. Lahir : ......................................................................................
Alamat : ......................................................................................
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NIK KTP : ......................................................................................

Terkait dengan Perjanjian Kredit No. ................................................. tertanggal

............................, yang mana kredit tersebut telah dalam kondisi Macet, maka berdasarkan
hal tersebut dengan ini saya menyatakan komitmen dan kesanggupan saya untuk
melakukan :
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Demikian Pernyataan ini saya buat dengan sebenarnya, secara sadar, tanpa adanya
paksaan dan/atau tekanan dari pihak manapun, apabila pernyataan ini ternyata
dikemudian hari tidak benar, maka saya bersedia dan tidak keberatan menerima segala
konsekuensi yang timbul dari pernyataan ini, termasuk namun tidak terbatas pada
penjualan bersama agunan kredit dalam perjanjian kredit tersebut diatas.

................., .........................................
Yang membuat pernyataan,

Materai
10.000