Cognovit Note Form – Fill Out and Use This PDF

________________________, Ohio

DATE: __________________

FOR VALUE RECEIVED, the undersigned(s) jointly and severally promise(s) to pay to

INTEGRATIVE STAFFING GROUP, LLC (ISG), its successors and assigns at its main office, the

principal indebtedness as shown on the monthly records of ISG, as the amount of receivables due by the

undersigned(s), as either a Principal and/or Guarantor, that have become past due in accordance with the

Staffing Agreement, incorporated herein by reference.

In the event that any payment of the above noted principal and/or late fees due shall not be made

in accordance with the said Staffing Agreement, then in such event, the entire amount of the principal

plus late fees shall become immediately due and payable without notice.

The undersigned Maker(s), waives demand, protest, and any lack of due diligence or delays in

connection or enforcement of this Note. The Maker(s) additionally hereby indemnify, defend and hold

harmless ISG, its owners, shareholders, officers, directors, employees, agents, harmless against any

liabilities, losses, damages, costs or expenses of any kind, including attorney’s fees which may be

incurred related to this Note. Maker expressly agrees to pay all reasonable attorneys’ fees incurred by

ISG in connection with collection of this Note.

Maker authorizes any attorney-at-law to appear in any court of record in the State of Ohio, or any

other state, after this Note becomes due, and confess judgment against the Maker in favor of ISG in the

amount calculated as described above, with interest and court costs, and release all errors, waive appeal,

waive service of process and stays of execution. This warrant of attorney to confess judgment shall

remain in full force and effect so long as any portion of the indebtedness evidenced hereby remains

unpaid.

This Note is to be construed and enforced according to and governed by the laws of the State of

Ohio. The Maker acknowledges that this Note was signed in _______________County, State of Ohio.

Warning - By signing this paper you give up your right to notice and court trial. If you do

not pay on time a court judgment may be taken against you without your prior knowledge and the

powers of a court can be used to collect from you regardless of any claims you may have against

the creditor whether for returned goods, faulty goods, failure on his part to comply with the

agreement, or any other cause.

MAKER: __________________________

MAKER: _________________________________

Company Name

INDIVIDUAL(s)

_

BY1 ______________________________

Printed name(s):_____________________

Title: _____________________________

__________________________________

Printed Name______________________

__________________________________