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RETAIL INSTALLMENT CO1~fTRACT ~ i
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Name d B~niness ~ ~ . , , ~ .
Address V ~ pbone e~~
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Seller re aells and ~~b~reD~~~
Bny purchsses the followin~ ~ooda on t!N t~rms and coadition~ ~et forth ia this coatr~ct;
c~r c~? ~a c~~~,~ . . . . . . . . . . . :
Model Article Seriai Na SeIW~ Price Dawn payment; ~
s?,~ Cs~ah . . . . . . . . . . . . . . . . . ~
r ) 1`i'~-in Allc~wance Q ~ .
` (Descripaca a Goods) ~ ~
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Item 1 mlaus Itenn t . . . . . . . . . . . . . . . . . . .
~ ~ I4) Inn~rance Premiums (Losa, dsmag~e or deatructim ;
o[gooda)
~ ~ (5) Credit Life ~ lde Iasur .
~ , Q~ / ~ (a) OUicial Fees ~t~+~~ . . . . . ~
v .(7') Principal Balsnc4 ~na d Iteans 4, 6~ 8)
f Ir - i - ~ " ' ~ ~•.~~,%`'fh~`.f~~ _ .
Dste to Insatil ~8~ Fiaance Ch~rge .
(9) Tlme Balance (Suan ct? & 8) . . . . . . . . . . . . . . .
(10j m.~e
~e P (Stiun Items 1 3 6~ 6). ~
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Buyer tgrees to pay aaid Time Balstnce ia ~ consecutive mmthly installmenta begianin~ on the ~Q ?k
~Y a, . and an the same day at each moatli thereaiter, each inatallmeat to be la the amount
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s oi a - escept the fiaal instailment which ahalt bc ; ~ ~ +
Tdis cantract wl~ea accepted by tbe.8eiler i sub~ect to the s and conditioas forth on the reverse aide hereoi. ~ • t
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~~a s~ ~a~u~ ~ ~r a a~~~~i~~~it~'t~'~'c~c t ,
between the p~rties. ~ af110u11t Of s~' 1~:.~ Ofa OOPy
~ ~ NOTICE TO BUYER ~n T~ ~ `
1. Dio l~lot Stan tWs ooatraci beton Ton nad it or it ii oontains saJ? blank spacea. Z. You are entfided to an e:act oopp of . i
the oontract you aian. S. Under t6e law, ~ou hare the ria6t to pay otY in ad~~noct the full unount due aad to obt~in a !
o~ ~1e THIS IS A RETAIL INSTALLMENT CONTRACT~
T
A E R E C
E I P T. B
Y T
H E BUYER OF AN EXECUTED
COFY O WHICR IS EREBY ACKNOWLEDGED. .
PALM B DISTRIBUTING O. ; - . ; ~
. 101~ . Lak~ Wor1h, F rida~ .
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- WNIT[.COrr TO ~i {iNT TO O~}ICt . . ; .
reuow eorr ro u nten nnTM ~~~ru or o~ew or oou+~rr wM~ r~eoKwsr ~s sar i;
; r~NR co?r ro ~e ~ec?w~KCO ~r ouuw
~ •wt corr To fs RttR~Nto w~vRCrtwsot - . ~ r~ E.
nnwrea w ewa~eou m~rmw~ oo.. rNe.. uucs MroRtx. ~tw. . , ' ,
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- STATE OF ~1`.te~%I~ " ~ , , - - _ _ _ _ _ ` -y- - . _ r .
: cotnv~rx oF 3i ~C ~ c~~
.,,.~••'Y, HERESY CERTIF'Y that on thia day personally appeared before '
me; ~h~.offi~er duly authorized to administer oaths and thke acknow-
leci4~~rents, f,~ ' ~
~ • tis me well knowr~ to be ~°3~~N''B'/uA~l~ :
tt~e p~rson }c~scribed i» and/~lexecuted the foregoing instrument and
ac~ow l~ dg~e d b e
fore me t
ha t
l,/~ execu t e d t
l
le same for t~~~uposes i=
th'ere.i~'ri expressed. / S. C .
- . YPT •WITNESS WHEREOF ~ I have hereun~O set n~ ~~r~•~ fixed .
, my official seal at . , said ~ ounty ~i~~:'S ; ~ ~ _
.~~Dr day of ~/,.s.y /fL~ ~ A 19G~ ' : C=~~~Y: W? _ _ + _
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~arNnr nreuc a ~a? a ~~Y .•'1 ' ~ `
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My Commission Expires ~
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