$ 00,000.00                              [city & state]
                                                 [date]


     For VALUE RECEIVED,  the undersigned (jointly and
severally,if more than one) promises to pay to _________
____________the principal sum of _______________________
____________DOLLARS, ($00,000.00) with interest from date
at the rate of ______  ( ) percent per annum on the
balance from time to time remaining unpaid.  The said
principal and interest shall be payable in lawful money
of the United States of America at ___[full address]____
______________________ or at such place as may hereafter 
be designated by written notice from the holder to the
maker hereof, on the date and in the manner following:
UPON DEMAND AFTER--------------------.

Maker's Address       _____________________________(SEAL)

                      _____________________________(SEAL)
____________________
                      _____________________________(SEAL)