Sample Promissory Note for Delayed Payments

When it comes to financial transactions, it’s important to have everything in writing to avoid any misunderstandings or disputes. A promissory note is a legal document that outlines the terms and conditions of a loan or debt. In the case of delayed payments, a promissory note can help establish clear expectations and protect the interests of both parties involved.

Here is a sample promissory note that can be used for delayed payments:

Promissory Note

Loan Amount: [Enter the amount of the loan]

Borrower: [Enter the name of the borrower]

Lender: [Enter the name of the lender]

Date: [Enter the date of the promissory note]

1. Terms of Repayment:

The borrower agrees to repay the loan amount in [enter number of installments] equal installments of [enter payment amount] on the [enter day of the month] of each month, starting from [enter start date], until the loan is fully repaid.

2. Late Payment:

In the event of a late payment, the borrower agrees to pay a late fee of [enter late fee amount] for each day the payment is delayed beyond the due date.

3. Default:

If the borrower fails to make any payment for a period of [enter number of days] days after the due date, the lender has the right to declare the entire loan amount due and payable immediately.

4. Governing Law:

This promissory note shall be governed by and construed in accordance with the laws of [enter governing law jurisdiction].

5. Entire Agreement:

This promissory note constitutes the entire agreement between the borrower and the lender and supersedes any prior agreements or understandings, whether written or oral.

By signing below, the borrower and the lender acknowledge that they have read, understood, and agreed to the terms and conditions of this promissory note.

Borrower’s Signature: [Enter borrower’s signature]

Date: [Enter date of borrower’s signature]

Lender’s Signature: [Enter lender’s signature]

Date: [Enter date of lender’s signature]

Please note that this is a sample promissory note and should be customized to fit your specific situation. It is advisable to consult with a legal professional to ensure compliance with local laws and regulations.

[Your Name] [Your Address] [City, State, Zip Code] [Email Address] [Phone Number] [Date]

[Recipient’s Name] [Recipient’s Address] [City, State, Zip Code]

Promissory Note for Delayed Payments

Loan Details:

  • Borrower’s Name: [Borrower’s Name]
  • Lender’s Name: [Lender’s Name]
  • Loan Amount: [Loan Amount]
  • Original Loan Date: [Original Loan Date]
  • Repayment Terms: [Repayment Terms]

Terms and Conditions:

I, [Borrower’s Name], promise to repay [Lender’s Name] the total sum of [Loan Amount] according to the following terms and conditions:

  1. Revised Repayment Schedule:
    • The original repayment schedule stipulated [Original Repayment Terms].
    • Due to unforeseen circumstances, I am requesting a revised repayment schedule as follows: [Revised Repayment Terms].
    • The first payment under the revised schedule is due on [New Due Date].
  2. Interest:
    • A [Fixed/Variable] interest rate of [Interest Rate]% per annum will be applied to the outstanding balance.
    • Interest will be calculated from the date of disbursement until the loan is fully repaid.
  3. Late Payment Fees:
    • In the event of late payments, a late fee of [Late Fee Amount] will be imposed for each late installment.
  4. Mode of Payment:
    • Payments can be made through [Accepted Payment Methods].
    • All payments should be directed to [Payment Address].
  5. Prepayment:
    • The borrower has the option to prepay the outstanding balance without incurring any prepayment penalties.


I, [Borrower’s Name], acknowledge and understand the terms and conditions outlined in this promissory note. I am committed to adhering to the revised repayment schedule and making timely payments as agreed upon.

Lender’s Consent:

I, [Lender’s Name], consent to the revised repayment schedule proposed by the borrower. I understand the reasons for the request and agree to the adjusted terms.

Dispute Resolution:

In the event of any dispute regarding this promissory note, both parties agree to seek resolution through mediation. If mediation is unsuccessful, the dispute will be settled through arbitration in accordance with the laws of [State].

Governing Law:

This promissory note is governed by the laws of the state of [State].


______________________________ Date: ______________ [Borrower’s Signature]

______________________________ Date: ______________ [Lender’s Signature]

Note: This promissory note is a legally binding document. It is recommended that both parties seek legal advice before signing.

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