Target language: Engels
Date:_____
I, the undersigned, affirm that I have received a loan of ______ NIS, on ________, from ________, I.D. ________ (daughter and legal guardian of parent), which will be considered a part of the compensation I am to receive upon the termination of my employment with _____________, I.D. __________________
First name, Surname, Signature
Passport no., Date