$........ ............................191..

........after date for Value Received,........promise to pay to the Order of........the sum of........Dollars, at........

with interest thereon at the rate of........per cent per annum, payable........annually.

This Note is secured by a Chattel Mortgage to........of even date herewith, on personal property in........and is to bear interest at the rate of........per cent per annum after........

No........ ...................................