FORM OF EVIDENCE OF INDEBTEDNESSEvidence of Indebtedness • May 3rd, 2005 • Assuranceamerica Corp • Fire, marine & casualty insurance
Contract Type FiledMay 3rd, 2005 Company IndustryThis agreement has been delivered as evidence of indebtedness of Sercap Holdings, LLC to Guy W. Millner, for accrued and unpaid interest in the amount of $2,965,127 owed by the Borrower to Millner under a promissory note dated January 23, 1998, and a promissory note dated January 1, 1999. This Evidence of Indebtedness is not intended to constitute payment of such accrued and unpaid interest.