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Instdllment Loan-Property Improve~uent Loan Ong~nal tor Ei.i~~h .
(~lu:• for Customer
• PROMISSORY NOTE P nk for Fiie Customer
E:?~R~S•xQ Pa•t ~i~~p~ . FIa. ~ibr~rry?. S~ . 19 7~
For value received, the undersignEd (which term shall include any endorsers or guarantors). jointly and
severally, promise to pay to the o:der of Florld~ 1l+ert ~t F~t Pft~a , the sum
of a1 ~h! hunct~re~d f ~v,~e •nd 20 ~~0 • • • • • ~ • ~ • • • • DOLLARS
(TOTAL OF PAYMENTS) in its office in Fort~ P/~~~ . Florida. corsisting of
Proceeds to Borrower 3s~OOa00 Unpaid Balance-AMOUNT FINANCED 9s21~~0)
Documentary Stamps S.~ Credit Report 10aQQ
Intangible Tax ~ Other Costs "D` -
Other Cost ~ ~f~!! Interest 5~~~'~~
Credit Life Insurance ~•61 TOTAL FINANCE CHARGE ~~'17
125.57 t1.2S o
Disability Insurance _ ANNUAL PERCENTAGE RATE -/o
Credit Life Insurance and Disability Insurance are not required for credit. Such coverage is available at
the above cost.
I desire Credit Life Insuranee JMlf C~ Kt~hlS
MAKER CO MAKER
I desire Disability Insurance _•~a~ ~~Qf~s
~ MAKER CO MAKlR
The Undersigned promises to pay the TOTAL OF PAYMENTS in monthly installments of $
each, commencing on the ~~y of , 19 7~+ and op the ~~h day of each
successive month thereafter. together with a final/balloon payment in the amount of due
on the ~ day of ~0• . 19 . If this note shall be prepaid in full, the undersigned
shall receive a refund of a portion of the FINANCE CHARGE computed by the "Sum of the Digits" method.
If any installment shall not be paid within ten (10) days after the same shall become due, a service
charge of y5.00 or 5% of the amount of such installment. whichever is less, may be made. If this note or any
installment thereof. shall be collected through an attorney at law. undersigned shall be tiable for the cost of
coltection, including reasonable attorney's fees equal to 10% of the principal sum or such larger amount as
may be reasonabte and just. -
If any instaltment shall not be paid when the same shall become due, the ent~re amount of this note, less
the amount of any rebates required by law. become due and payable at the election of the holder, and such
I unpaid amount thereafter shall continue to bear interest at the rate used to compute the FINANCE CHARGE
i until paid.
Presentment. Notice of Dishonor and Notice of Non-Payment hereby are waived by each maker. endorser.
or other party to this note. and each of them hereby do vraive all exempt+ons. whether homestead or other-
wise, to which they or any of them now or hereafter be ent~tled to under the laws of the State of Florida. o~
of any other State. .
Plorid~ l~~~t st Fort ~'~Ip as securit
The undersigned hereby grant to Y.
a lien on that real property in:
St • luct• ~
. County, Florida, known as No. Street
Fort P~vp . State) flerldi
(City) ,
and warrant that: (a) the undersigned are the owners and the sole owners, of the above described proaerty: (b)
that the undersigned have disclosed to the bank all pnor I~ens on the above described property: and (c) that the
proceeds of this loan will be used for the improvement. alteration or repair of the above described premises.
If the above described property is transferred from the undersigned, whether voluntarily or involuntarily, cr
~y operation of law, if the undersigned or any of them becorrtes insolvent or a bankrupt; or if the above de-
scribed premises are destroyed..either by fire or otherwise. at any t~me pnor to the full payment of this note.
then. at the option of the holder hereof. the unpaid balance of this note sh~ll immediateiy become due and
payable. without demand or notice.
THE UNDERSIGNED. AND EACH OF THEM ACKNOWLEDGE THAT AT LEAST THREE BUSINESS
DAYS PRIOR TO THE EXECUTION OF THIS NOTE. THEY RECEIVED ALL OF TNE DISCLOSURES PROVIDED
FOR UNDER THE CONSUMER PROTECTION ACT. THAT THEY ENTERED INTO AN AGREEMENT CONSUM-
ATING THIS TRANSACTION, THAT THEY HAVE NOT MAILED A NOTICE OF RESCISSION TO THE BANK.
AND THAT THEY HAVE BEEN FURNISHED A COPY OF THIS NOTE. j
Dated the date first above written.
--1230 ~moew! Aw• - - ' - - L.S.)
(~ddressl .~MM• C~ ~~f
~
' ' "2--_ll.S.)
(address)
~ ~ ~
~ - ~ : ~ 223 P~~E 269~
Form - 456 - Blan4