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<br />~ <br /> <br />RETAIL INSTALLMENT CONTRACT <br />HOME SOLICITATION SALE <br /> <br />WHITE - ORIGINAL <br />BWE - BUYER <br />BWE - BUYER <br />GREEN - DEALER <br />CANARY - TIL <br /> <br />Co-Buyer <br /> <br />Buyer (Print ~r Ty ;tJI ~ E ~'~' '- <br />Name . V - / 11/ f / <br />I ' '_'-.If <br />Stre~Addres;..., 'J J J \1 /( I ~ ~ < /:J J <br />:;> jL ,-"... 0 WI C-/ /V ...,.) /'C of , <br />City & State , /) A ~ <br />/;4 j/Jf ,1'-'-' " " ,- , <br />Seller (Creditorl ___ <br />Name & Addre~s4 a 5T?f It:.. <br />Salesman's Name & Address <br /> <br />Street Address <br /> <br />City & State <br /> <br /><~/::./ c <br />_.- I~.~. "',IV 7 <br /> <br />I /Ii'? fie /I L1 License Number <br />Itrl'~, -6 L rTGO$:'~5' //0 <br />License Number <br /> <br />Te.lePhone Number,,/ Ico~act Date ,I <br />/0$1 -;(O7~ c,... ;ZO- t;~ <br />Telephone Number <br /> <br />Serial No Description (Goods/Services) <br /> <br />/~Wt:.~,fe .II, ~1C)V 5;{:.kd:/':':-' <br />_,_ J C:-7: I C- U ~ . . r:::. <br /> <br />~ -l-iER r/.i.J~ <br /> <br />AMOUNT <br />$ 4~ /Xi, (.1,~ <br />$ <br />$ <br /> <br />List security retained from previous Contract: <br /> <br />The Buyer agrees to purchase the above described goods and services, hereafter called "property" <br />for the Total Sale Price. ' <br />Buyer promises to pay Seller the total of payments in consecutive monthly payments according <br />to the payment schedule shown opposite. Interest after maturity shall accrue at the highest lawful <br />contract rate. . <br />A security interest in the property shall remain in the Seller or his assignee under the Uniform <br />Commercial Code until this Security Agreement is fully performed. Buyer hereby acknowledges delivery <br />and possession of the property. The property shall remain personal property and shall not become <br />real property no matter how affixed thereto. <br />Buyer also promises to pay to the Seller or other holder of this Security Agreement a late charge <br />on each payment of this Security Agreement in default more than 10 days in an amount equal to <br />5% of each such payment. <br />If the indebtedness is accelerated or prepaid in full, the Buyer will be allowed a rebate of the <br />unearned portion of the finance charge, after first deducting an acquisition charge of $15.00 for <br />the months prepaid computed by the "Rule of 78's", provided, however, if this contract is dated <br />on or after October 1, 1993, and has an original term of more than 61 months, the rebate will be <br />computed according to the actuarial method, after first deducting an acquisition charge of $15.00. <br />The following minimum charge may be retained by the Seller; $12.000, if the amount is $50.00 <br />or more, $7.50, if the amount financed is greater than $25.00 but less than $50.00; or $5.00 if the <br />amount financed is $25.00 or less. No refund of less than $1.00 will be made. <br />Seller may, at its option, add subsequent purchases of goods and/or services made by Buyer <br />to this agreement, in which event all terms and conditions hereof shall apply equally thereto, and <br />the total price of such additional goods and/or services, the finance charge and installment pay- <br />ments may be increased. Goods purchased under previous contracts shall be security for the goods <br />purchased under subsequent contracts until such time as the deferred payment price under the <br />previous contract is fully paid. <br />Each payment on this agreement shall be allocated to the purchases made on this agreement <br />and to all previous installment purchases not paid for in full as of this date on the basis that the <br />items first purChased shall be deemed first paid for, and, in the case of items purchased on the <br />same date, the lowest priced item shall be deemed first paid for. The Seller's security interest in <br />the goods shall cease as each item is paid in full. <br />The Buyer and Seller agree to the "Statement of Additional Covenants" set forth on the reverse <br />side hereof, which the undersigned each agree shall constitute a part of this Security Agreement. <br /> <br />Same as Cash Option <br /> <br />o If checked and signed or initialed below by the Seller and Buyer, this contract contains a "Same <br />as Cash" Option. If you pay the entire Unpaid Balance of Cash Price (Line C) and the Net Un- <br />paid Balance on Prior Contract (if anYI (Line D) within of the date of this <br />contract, no Finance Charge will be assessed, and all other charges (if anYI will be rebated. <br />The "Same as Cash" option is void unless you pay each regular monthly payment when due <br />during the "Same as Cash',' period, <br /> <br />If the Contract is not prepaid as described above during the "Same as Cash" period, the "Same <br />as Cash" period is not interest-free. <br /> <br />Seller: Buyer: <br /> <br />Credit Insurance is not required to obtain credit. I understand I may elect to purchase credit insur- <br />ance from the Seller or I may assign a policy I already have or I may buy a policy from anyone <br />I choose to cover this transaction. The only insurance we provide is through an affiliated company <br />of the assignee of this Security Agreement and that company expects to profit from the insurance. <br />Credit Life Insurance I want Credit Life Insurance. <br />'\. <br />X r. <br /> <br />I want Credit Accident and Health Insurance. <br /> <br />Premium $ <br />Credit Accident and <br />Health Insurance <br />Premium $ <br /> <br />X <br /> <br />ITEMIZATION OF AMOUNT FINANCED <br />CASH PRICE ........... .. .. .. .. .. .. . .. $'1-& In), d '~A <br />CASH DOWN PAYMENT ..... $ ~-.:; t>t>,. "-0 <br />TRADE-IN ................ $ {ff <br />. , , <br /> <br />(Describe) <br />lUTAL DOWN PAYMENT ..................... $ <br />UNPAID BALANCE OF CASH PRICE (A MINUS BI $ <br />NET UNPAID BALANCE ON PRIOR CONTRACT ... $ <br />OTHER CHARGES: <br />TO INSURANCE COMPANIES: <br />CREDIT LIFE INSURANCE $ <br />ACCIDENT & HEALTH <br />INSURANCE .......... $ <br />PROPERTY INSURANCE $ <br />NON-FILING INSURANCE $ ;:! 5',. . p(j <br />TO PUBLIC OFFICIAlS...' $ I ~',3.? ,0 1'~ 3-5' <br />lUTAL OTHER CHARGES ... '." '... . . .. ... $ '- ~, . E <br />AMOUNT FINANCED (C+D~EI..:...".. .'.', ,. .$"" /39, 3 '5 F <br /> <br />::)/)1), /'J..tl B <br />?'t / ()-() , vCl C <br />I!f D <br />, <br /> <br />@ <br />/ <br /> <br />DISCLOSURE STATEMENT <br />AMOUNT FIN.ANCED (The amount, of c,r,e dit , , AI., / ,~ ~' 3 ~ <br />proVided to you or on your behalf) $ 'ZZ...lL _' oJ <br />FINANCE CHARGE (The dollar amount. the !' '. GlI rj, .P I 0 <br />credit will cost youl ' " ' $ . , <br />lUTAL OF PAYMENTS (The amount you will,":'" , <br />have paid after you, have fj'lade all. / ~~L'" "'ZI' <br />payments as scheduledl", ,'" :~'. ~$ f#? i/V J I ...xp F+G <br />lUTAL SALE PRICE > (The total cost of your..'. . <br />purChase on credit,'incl~i~lI wu~ /- ~ ('5': <br />downpaymentof$ ~OV, ".).:.$lp V , <br />ANNUAL PERCENTAGE RAT, E ,.,.,(The ~t.o, ~.~ . . <br />your credit as a yearly ratel J JJ. 71.. "0/0 <br /> <br /> <br />Your payment schedule will be: ., " <br /> <br />Number of Amount of When Payments Are Due <br />Payments Payments <br /> <br />'PO <br /> <br />$/0''''', A onthIY,/'O'" ""0 C <br />J v Starting - tX. - I <br /> <br />$ <br /> <br />Security: You are giving a security interest in the goods or property being <br />purchased. Property sectiring'anotlier'conti\ct\Withus 'may also <br />secure this contract. . , <br />late Charge: If a payment is more than'10 days late, you will be charged <br />5% of the payment. <br />Prepayment: If you pay off early, you wiD be entitled to a refund 01 part of the <br />finance charge. <br />