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FOR USE IN THE STATE OF NEBRASKA ' PAGE 2 OF 4 INSTALLMENT SALES CONTRACT AND MORTGAGE f C, CO Es 135970 CONTRACT NO. You (3eller/Mortgagee) 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 Sale Price is the 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 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 the payment schedule below. J SUMMARY OF SALE. Base cash price $ + tax F ,( •CG = $ Total cash price $ e�/{/ CC - Cash [total] down payment $ iE • Ff = Unpaid balance of $ ITEMIZATION OF THE AMOUNT FINANCED OF $ SS "�Ct eC C $ Y C Amount credited to this contract (Same amount as the "Unpaid Balance. ") Amount paid on net balance from prior contract with you. (e) 0 Amount( s paid to others on my behalf: to insurance company for Credit Life insurance $ G to public officialsil' Ireco Mg fees (e $ �Lf to insurance company for Accident and Health insurance $ G to (Specify) ANNUAL FINANCE Amount Financed Total of Payments Total Sale Price PERCENTAGE CHARGE The amount of credit The amount I will have The total cost of my purchase RATE The dollar amount the provided to me or on paid after I have made all on credit, including my down The cost of my credit as a credit will cost me. my behalf. payments as scheduled. payment of $ G GC' 6`L yearly rate. �.zr �� "�� �'s-�.�� 1$ sad, My payment schedule will be: Number of Payments J Amount of Payments I When Payments are Due I st Payment $ �r�� z13 e First Payment Due 4 CC $ J �' �� lch consl subsequent installments on the ve month until paid in full. each day of INSURANCE Credit life insurance and credit disability insurance are NOT required to obtain credit, and will not be provided unless I sign and agree to pay the additional cost. Type Premium Term Signature Credit Life I want credit life $ insurance. Signature — Buyer S�gna[ure — Co -Buyer Credit Accident I want credit accident & Health $ f'4` �r �r and health insurance. Buyer 6G C ignature — Security: I am giving you: 1. a security interest in the goods, services and property being purchased, and 2. a mortgage on my real estate at my "ADDRESS" below and legally described on pa e , hereof. Filing/Recording fees $ Late Charge: If a payment is more than fifteen (15) days late, I will be charged 5% of the installment payment or $25.00 whichever is lesser. Returned Check Charge: I will be charged $15.00 for any check I give You which is returned unpaid by the bank or other financial institution. Prepayment: If I pay off early, I will not have to Pay • minimum finance charge of $10.00 (which is defined as • "penalty" under federal law). --► I will review other portions of this contract for additional information about non - payment, default, any required repayment in full before the scheduled date, and prepayment refunds and penalties. e means an estimate. 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 side) of this contract as security for all amounts due to o and r this Installment Sales Contract and Mortgage. I give you authority to obtain and insert the legal description of my real estate hereon at a later time. Buyer ® "" Co -Buyer SELLER WILL NOT INITIATE A FORECLOSURE OR SIMILAR ACTION WHICH COULD CAUSE BUYER TO LOSE BUYER'S HOME, EVEN IN THE EVENT OF DEFAULT. SELLER MAY RETAIN A LIEN AGAINST THE HOME UNTIL BUYER'S CONTRACT OBLIGATIONS HAVE BEEN MET. 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 begin under this Contract. NOTICE TO THE BUYER 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. 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 FINANCE AND INSURANCE CHARGES (IF ANY). 4. THIS INSTRUMENT IS BASED UPON A HOME SOLICITATION SALE AND IS NOT NEGOTIABLE. BUYER'S RIGHT TO CANCEL I HAVE BEEN ORALLY ADVISED THAT I MAY CANCEL THIS AGREEMENT AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. (I HAVE READ THE ACCOMPANYING NOTICE OF RIGHT TO CANCEL FORM FOR AN EXPLANATION OF THIS RIGHT.) COPY RECEIVED: I acknowledge receipt of a completely filled in copy of this contract along with two (2) copies of the Notice Right to Cancel Form. y IN WITNESS WHEREOF, this Installment k `t Sales Contract and Mortgage has been signed on this r day of lq d�f% BUYER'S "ADDRESS" �� Y Count City y� d��i lf Y � Telephone No. State / � Zip THE PACESETTER CORPORATION (SELLER- MORTGAGEE) By. / (AUTH t O) By: / C _ l/ (FACTOKY REPRESENTATIVE) � Vii, � BUYER- R G /AGOR /' BUYER- MORTGA R -PR NTED NAME _ k_, C __ gi,� c k \1 CO- BUYER - MORTGAGOR 7r -�UQ- / -'Cre -tat, CO- BUYER - MORTGAGOR - PRINTED NAME 7039 SM- 101- NE -F /IH PACE ORIGINAL FINANCIAL INSTITUTION