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Jack : ~iRYr•r'~y . 11t~•1 ..`:~.~t~...JC•1?~...~n*I~ titra~t.~..'.~rt. .~;::~.C`.~
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(Nam~) ( No. and Saee~1 (C~~y1 lStace)
(Custome~), fo~ valuable co~sideration receipt of which he?eby is acknowiedged~ hereby grants to
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.
(the Secu~ed Party). a Security I~terest in d~at property described below in Parag~aph 12 and any and all i~-
ueases. proceeds. parts, accessories. atwchments, special t~ols, addiaons. accessions and substitutions d?e~e-
to or d~erafor (the Collatesa!), to secure payment oi the indebtedness evidented by d~is as~eement. any sxte.~-
sions or renewals thereof. and a~y and all liabilities. direct or indirect. absolute or contingent. now existing or
he~eafter arisin= of Customer co Secured Pa~tr and the perfo~mance of all the p~ovisions of fiis Agreemen~ _
Customer (which tertn shall include all e~.dorsers or guarantors~ and if mo~e tha~ one, each of d~em jointly and
-~rt ^i~r~et..:.lori::` .
sere~ai~y1 aom~ses co par to ~he order of Secu~ed Parcy at
the "TOTAL OF PAYMENTS"' +n the amount of 5... ~~J~:~: :~~.computed as follows:
I. PROCEEOS TO CUSTOMER S....':~~~~e~~ PREPAID FINANCE CHARGE 5... F'.%G,^2,
2. OFF{CIAL FEE~ANO TAXES S. AMOUNT FINANCED (11 Dlus (2) ;
- pfus (3) minus ~4) 5....~.~:::.'.~? :
Lie~ Search. 5........~ : Sat~sfacaon ' ~
of Ex~sting Lien, S'..'... : F_~~~8. 6. FINANCE CNARGE ~
s.,,.,,..... Intang~ble Tax. S. . Prepa~dFinanceCha~ge S..
. • ,
Docume~cary Swmps, 5....~ ~~~~n Credit Life Insurance 5....-0.:....... ;
~ C~edi! L~fA a~d O~sabil~ty j
Other, ..l ~ 5.....:.ann
.
TOTAL OFFICIAL FEES & TAXE~ S. ~.:r.l~n...... Insurance 5.....,(~..-.••.• :
3. INSU~ANCE: C~ed~c Report ~ S~~i~•••••••••
Term.~!......Monchs Incerest f''~ S••; .'!.t ~r•~S '
~~......Collision 5...._!L_.Deduct~ble Other : . . .......s.........":.- '
-~-...Fire 8 Theft.....J1,Comprehensive. TOTAL FINANCE CHARGE 5... ~..t:e~7•i.~
n_ C;,~-,~;;,~~ s~~:•,;or.a~ coverage 7. TOTAL OF PAYMENTS 5,,,.11y4~~-~?`•
~~'~!.~~,~,Cred~t L~fe:'n' ...Cred~c Life 8. THE FINANCE CHARGE EXPRESSED~~S~~~ ;
and U~sab~l~q AN ANNUAL PERCENTAGE RATE =
TOTAL COST OF INSURANI":E 5...••-•••--••••: 9. PAYMENT SCHEDULE:
Customer may ~hoose ehe person ehrough Cuscomer prom~ses to pa S c re Parcy ehe ~
'f 1 ~-r`~
whom the ~nsurance ~s co be obca~ned. " TQca 1 o f Paymen ts" s:::~..': p ay a b l e ~ n '
_
....:j:... equal ~nstallments of 5....~: /'.....r.each `
CREO~T LIFE INSURANCE, AND CRED~T LIFE 8. ~ommencing on i9..7i: and on '
OISABILITY INSURP.NCE ARE NOT REQUIRED FOR ~e same day of each successive month togecher
CREOIT. SUCH INSURANCE COVERAGE IS AVAIL- ~,,~~~h a Balloon• F~na` paymenc of S.l,i?..:.r.....
ABLE ~OR T~{E TERM oF TH1S AGREEMENT AT payabte on ..:'~-:nP..~.::...... (9... ~~l chis Agcee-
THE FOLt~R~~N~ COST. ment shatl be prepa+d in full. Customer wili be =
s~~....:'.:.:..fo~ C~edit L~fe Insurance entitled co a refund of a portion of [he FINANCE ~
j„-,,......,.,fo~ Credic L~fe and D~sability ~HARGE. afcer deducung an acquisiuon charge ~
. ln~~~r^n~a 1 .i 1...11 ~ d
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1 desire~Credit l~fe tnsurance or ?C?ed~t the sum of the d~g~ts method. ~
~ L~fe and D~sability Insurance on the I~fe of. ~
~
~ !une 1?, . .1:r~........
--.~^~ii~Y~~%~' ~ i0. The FINANCE CHARGE will beg:n to accrue on
~ uston,e.l...
~~a«ti"' ehe date che Proceeds prov~ded for hereunde~ are
~ .....-ttla«1 ....................~................-7~~~i~R;~;;.. advanced co cne Cuscomer =
~
~ I 1. Time is of the essence of this agreement. Customer agrees to pay Secured Parq, w~thout offset ot any k~nd.
a delinquency charge on any instalimenc not pa~d within 10 days of ~ts due date, in the amount of 5`10 of suc~~ ~n- _
stallment or 55.00 M?hichever ~s less. In add~t~on. Customer agrees to pay such expenses ~ncurred by Secured
Party in the event of default or in effecung collecaon hereunder as may be allowed by law, cncluding at*.orneys'
fees equal to 10 : of the pnnc~pal sum or such larger amoun[ as may be reasonable and ~ust. The '.~ss. ~n~ury o?
d~struction of the calla:eral w~ll not release buyer from any obl~gat~on hereunder. ~ _
12. Customer hereby g~ves to the Secured Parcy a secur~ty ~nceresc in ehe follow~ng described collaceral:
Year Make ~t~el Seria! Num4x~r _ Cas1. f'nce
~ 1 ~E7 3i It°K~rr -~:+hi 1P h,r~e ~ P4.;.'_ .:ll~6~_ - ! i
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~IUS ~ riCl~s•~r` •i. 1(~~ ~~2 [1 ~ ( -~~_-.1rA ~~1'~lt^S~. 1'^rl~j'=1^f~ lI`. j~~i'~ ~'~3~1~ 1,=^P! _
nf FR! '1'.1~ `~~:p'1rf~5 t• ~a••ftl~' t7r•~.
~ _ 1
1 3- TAe sta ~D~ rea~~•ed ~y ChaDter 201. Flor.d~ Statu[es. ~ave Oeen piaced on cne o.~~:~ a% pmm,ssory ~ast.u•*.~nl anC w•~i !,c :~ace~ o~.
~ anr a.ld~Uuoal aN 1~~'~I,~r ni[~u~nCnr tna2 ^+aY ~ So SecureJ-
Tti~s Agreement +s sub~ec: co ttie aadiuonal prov~s~ons set forth on the reverse s~de hereof, the same be~ng
~ncorporaced here~n br reference.
- The Debtor(s) acknowltdges receipt of
EXECUT~D THIS... 1~... day of 19....?:'~ an exact and true copy ot thi tract. =
_
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THESECURED PARTY ' ~
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By ~ ~.•t~.~. C . _ ....i... ~l.. ~ .
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