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FOR USE IN THE STATE OF NEBRASKA IQ- 1,g "% 7Jj SALES PAGE 2 OF 4 INSTALLMENT SALES CONTRACT AND MORTGAGE / CONTRACT NO. 137716 You,(SelloFF/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. Se f F� SUMMARY OF SALE: Base cash $ rice ,� P D, v +tax .so , e y =$ �.� � p. o d p O Total cash price $ 3.3 ?o.0 a - Cash [total] down payment $ _5 po , e j = Unpaid balance of $ o? O FD , - J ITEMIZATION OF THE AMOUNT FINANCED OF $ 3a o ai? 1-+ $ 07 &?�D . ©a Amount credited to this Contract (Same amount as the "Unpaid Balance. ") $ 0,0,00 Amount paid on net balance from prior contract with you. (e) Amount(s) paid to others on my behalf: $ D v , 0 o to insurance company for Credit Life insurance $ o - o a to public officials for filing /recording fees (e) $ , o a to insurance company for Accident and Health insurance $ q o , oo to (Specify) �-, / /e 5e - , 6 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 $ 'So e . 6Z . yearly rate. $ and health insurance. to % 1 $ oca, aa 1 $ 02 G kd 1 $ V,7 O schedule will be: Number of Payments I Amount of Payments I When Payments are Due 1st Payment $ /76, 29, e First Payment Due 1.1-13 -C/ $ O All subsequent installments on the same day of each consecutive month until paid in full. 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 T mrn? Signature Credit Life I want credit life $ insurance. Signature —Buyer Signature — Co -Buyer Credit Accident I want credit accident & Health $ and health insurance. Do• t7 9 O V Signature — Buyer Security: I am giving you: (a) a security interest in the goods, (Products) being purchased, d, (b) if, and only if initialed ® t Buyer ® Co -Buyer a Mortgage on my real estate at my "ADDRESS" below. Filing/Recording fees $ t � D • o 0 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. Prepayment: If I pay off early, I will not have to pay a 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: If and only if I initialed the Security section above, I 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 you under 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. 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 .1 now have a balance due you, from a.prgvious Contract, 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 BEfORQ`EAfIIG IT OR 'IF, It, CONTAINS BLANK SPACES. 2. YOU ARE ENTITLED TO A COPY OF THE CONTRACT YOU SIGNED. 3. FINANCE ANDAINSURA CE FULL RGES (II ANY)• 4. THIS INSTRUMENT IS BASED UPON'A AND IN SO HOME SOLICITATION SALE AND IS NOT NEGOTIABLE. OF THE UNEARNED BUYER'S RIGHT TO CANCEL 1 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 of Right to Cancel Form. IN WITNESS WHEREOF, this Installment Sales Contract and Mortgage has been signed on this y day of BUYER'S "ADDRESS" :5 tell 7 S� City 0� r e N�( Slur 7�County //9 Telephone No. 0 f ._ 3e S/ - % re 2-- THE PACESETTER CORPORATION (SELLER- MORTGAGEE) By: (AUTHORI OFFICER) By. CTORYR PRESENTATIVE) Ems— zip 6 ffo/ NO DU i UK— rv1UK1 UAUUK �/// Zy/IrSSY � /T_,I BUYER - MORTGAGOR - PRINTED NA CO- BUYER - MORTGAGOR P CO- BUYER - MORTGAGOR- PRINTED NAME 7039 SM- 101- NE -1/11 PACE ORIGINAL FINANCIAL INSTITUTION