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FOR USE IN THE STATE OF NEBRASKA PAGE 2 OF 4 <br />12- 15a 8�qALES <br />INSTALLMENT SALES CONTRACT AND,MORTGAGE CONTRACT NO. 135871 <br />You (SelleOMoligagee) have quoted me (Buyer[s] /Mortgagor[s]) a Cash Price and a Total Sale Price for the Products described on page 1 of this contract. The Total <br />Sale Price is thq total cost of the Products and services if I buy on credit, subject to approval of my credit. I (Buyer) now choose to buy and you agree to sell, for the <br />Total Sale Price' set forth below, the Products and services described on page 1. I agree to pay you the Amount Financed and the Finance Charge in accordance with <br />the payment schedule below. <br />SUMMARY OF SALE: Base cash price $ ,64 tax <p, D d y = $ UGC q 0 <br />Total cash price $ d tJ - Cash [total] down payment $ Unpaid balance of $ C:) <br />ITEMIZATION ITEMIZATION OF THE AMOUNT FINANCED OF $ (�'` �UV . Ud <br />$ 1 • U 6 Amount credited to this contract (Same amount as the "Unpaid Balance. ") 11-6 <br />$ n • o0 Amount paid on net balance from prior contract with you. (e) '17 <br />Amount(s) paid to others on my behalf: 00 <br />$ C-1 • U 0 to insurance company for Credit Life insurance $ i3b • d to public officials for fit /recording fees (e) <br />$ G -Cis to insurance company for Accident and Health insurance $196-60 to (Specify) i �� Yc <br />ANNUAL <br />FINANCE <br />Amount Financed <br />Total of Payments <br />Total Sale Price <br />PERCENTAGE <br />CHARGE <br />The amount of credit <br />The amount I will have <br />The total cost of my purchase <br />RATE <br />The dollar amount the <br />provided to me or on <br />paid after I have made all <br />on credit, including my down <br />The cost of my credit as a <br />credit will cost me. <br />my behalf. <br />payments as scheduled. <br />payment of $ <br />yearly rate 3 % <br />/ Q <br />s i f - ,4 � <br />���Ci . C�� <br />p <br />��/, 0 d <br />s <br />My payment schedule will be: <br />Number of Payments I Amount of Payments I When Payments are Due <br />I st Payment e ot9P I a First Payment Due _Y 0 U <br />$ All subsequent installments on the same day of <br />each consecutive month until paid in full. <br />INSURANCE <br />Credit life insurance and credit disability insurance are NOT required to obtain credit, <br />and will not be provided unless I sign and agree to pay the additional cost. <br />Type <br />Premium <br />Tmrolsn) <br />Signature <br />Credit Life <br />I want credit life <br />$ <br />insurance. <br />ignature — er <br />Signature — Co -Buyer <br />Credit Accident <br />I want credit accident <br />& Health <br />$ <br />O <br />and health insurance. <br />V , <br />Signature — Buyer <br />Security: I am giving you: <br />1. a security interest in the goods, services and property <br />being purchased, and <br />2. a mortgage on my real estate at my "ADDRESS" below <br />and legally described on page 3 hereof. <br />Filing/Recording fees $ � 7-8 , U d <br />Late Charge: If a payment is more than fifteen (15) days <br />late, I will be charged 5% of the installment payment or <br />$25.00 whichever is lesser. <br />Returned Check Charge: I will be charged $15.00 for <br />any check I give you which is returned unpaid by the bank <br />or other financial institution. <br />Prepayment: If I pay off early, I will not have to pay <br />a minimum finance charge of $10.00 (which is defined as <br />a "penalty" under federal law). <br />- -� I will review other portions of this contract for <br />additional information about non - payment, default, any <br />required repayment in full before the scheduled date, and <br />prepayment refunds and penalties. <br />e means an estimate. <br />MORTGAGE: I hereby convey and mortgage to you, as Mortgagee, my real estate at my "Address" below and more particularly described on page 3 (reverse <br />side) of this contract as security for all amounts duALIEN er tha Installment Sale C ntr t and Mortgage. I give you authority to obtain and insert the legal <br />description of my real estate hereon at a later time Buyer Co Buyer <br />SELLER WILL NOT INITIATE A FORECLOSUSIMILAR ACTION WHI COULD CAUSE BUYER TO LOSE BUYER'S HOME, EVEN IN THE <br />EVENT OF DEFAULT. SELLER MAY RETAIN AGAINST THE HOME UNTIL BUYER'S CONTRACT OBLIGATIONS HAVE BEEN MET. <br />CONSOLIDATION: If I now have a balance due you from a previous purchase, I understand I must continue to make my payments on that obligation until payments <br />begin under this Contract. <br />NOTICE TO THE BUYER <br />1. DO NOT SIGN THIS CONTRACT BEFORE READING IT OR IF IT CONTAINS BLANK SPACES. 2. YOU ARE ENTITLED TO A COPY OF THE CONTRACT YOU SIGNED. <br />3. YOU MAY PAY OFF THE FULL BALANCE DUE UNDER THIS CONTRACT AT ANY TIME, AND IN SO DOING YOU MAY BE ENTITLED TO A REBATE OF THE UNEARNED <br />FINANCE AND INSURANCE CHARGES (IF ANY). 4. THIS INSTRUMENT IS BASED UPON A HOME SOLICITATION SALE AND IS NOT NEGOTIABLE. <br />BUYER'S RIGHT TO CANCEL <br />I HAVE BEEN ORALLY ADVISED THAT I MAY CANCEL THIS AGREEMENT AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER <br />THE DATE OF THIS TRANSACTION. (I HAVE READ THE ACCOMPANYING NOTICE OF RIGHT TO CANCEL FORM FOR AN EXPLANATION OF THIS RIGHT.) <br />COPY RECEIVED: I acknowledge receipt of a completely filled in copy of this contract along with two (2) copies of the Notice of Right to Cancel Form. <br />IN WITNESS WHEREOF, this Installment Sales Contract and Mortgage has been signed on this day of } <br />BUYER'S "ADDRESS "�p�1 CfI s'4� 5� - City LS�-�d a Y� � j' County <br />Telephone No. ��V D �✓� 7 G CD State Zip <br />THE PACESETTER CORPORATION (SELLER- MORTGAGEE) <br />By: L <br />(AU RI OFFICER) , <br />By: Le z <br />7FArTORY REPRESEN I AT i V E) <br />7039 SM- )o) -NE -FAH PAGE 2 ORIGINAL FINANCIAL INSTITUTION <br />