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99111209
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Last modified
3/13/2012 8:09:40 PM
Creation date
10/21/2005 1:29:16 AM
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99111209
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FOR USE IN THE STATE OF NEBRASKA i�.� ��rjj�Jn PAGE 2 OF 4 <br /> . <br /> � - , INSTALLMENT SALES CONTRACT AND MORTGAGE � r�� CONTRACT NO. ���H`'t V <br /> You (Seller/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 <br /> 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 <br /> Total Sale Price set forth below, the Products and services described on page l. I agree to pay you the Amount Financed and the Finance Charge in accordanc�th <br /> the payment schedule below. � <br /> SUMMARY OF SALE: Base cash price $��yd�UV + tax U�,vv = $ � ��� <br /> Total cash price $ ��•QV – Cash [total] down payment ����V ' ` = Unpaid balance of$ ��L/v'U� � <br /> ITEMIZATION OF THE AMOUNT FINANCED OF $ UU,OC� , � <br /> $ WAmount credited to this contract (Same amount as the "Unpaid Balance.") � <br /> $ �a ya.�Amount paid on net balance from prior contract with you. (@� I'� <br /> Amount(s) paid ro others on my behalf: � <br /> $ ���to insuraace company for Credit Life insurance $�to public officials for filing//recording fees(@� <br /> $ �.�o insurance company for Accident and Health insurance $��12�lZ(�to (Specify) �s f l�P 5'!Qi'�'�! . <br /> ANNUAL FINANCE Amount Financed Total of Payments Total Sale Price <br /> PERCENTAGE CHARGE The amount of credit The amount I will have The to[al cost of my purchase <br /> RATE The dollar amount the provided to me or on paid after I have made all on credit, including my down <br /> credit will cost me. my behalf. payments as scheduled. a ment of$ QU�� <br /> The cost of my credit as a P Y • <br /> yearly rate. <br /> /! o ��o $ ��o3l�,c� $ �'.�.oc� $ /� /3G.ov $ /`�, �3�, o0 <br /> My payment schedule will be: Security: I am giving you: <br /> 1. a security interest m the goods, services and property <br /> Number of Payments Amount of Paymen[s When Paymen[s are Due being purchased, 3lld <br /> lst Pa ment $ @ First a ment due Lt� . � _o�%� �• a mortgage on my real estate at my ADDRESS"below <br /> Y IC�,��Q P Y and legally descr�bed o��pa"g'e 3 hereof. <br /> Q All subsequent installments on the same day of Filing/Recording fees $ X1,G)U <br /> $ �f�/2,�Q Late Charge: If a payment is more than flft2en (15) days <br /> �1 each consecutive month until paid in full. o <br /> INSLT ANCE late, I will be charged 5/0 of the installment payment or <br /> Credit life insurance and credit disability insurance are NOT required to obtain credit,and �25.�� whichever is lesser. <br /> will not be provided unless I sign and agree to pay the additional cost. Returned Check Char�will be charged$15.00 for any <br /> check I give you which is returned unpaid by the bank or <br /> Term Si na[ure <br /> TYPe P�m��m ,,,,,,,., g other financial mstitution. <br /> Credit Life I want credit life � Prepayment: If I pay off early, I may have to pay a <br /> insurance. min�mum finance charge of$10.00 (which is defined as a <br /> Signature—Buyer <br /> � �� "penalty" under federal law). <br /> hO,D� `� —� I will review other portions of this contract <br /> �� s�g�ac�re—co-s�y�� for additio�al information about�on-payment, default, any <br /> Credit Accident I want credit accident - required repayment in full before the scheduled date, and <br /> & Health $ and health insurance. � prepayment refunds and penalties. <br /> ��v� Signamre—Buyer @ 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 side) <br /> of this contract as security for all amounts due to you under this Installment Sales Co tract and MoRgage. I give you authority to obtain and insert the Iegal <br /> x <br /> description of my real estate hereon at a later time. � ('� �� Buyer � Co-Buyer <br /> SELLER WILL Q INITIATE A FORECLOSURE OR SIMILAR ACTION WHICH COULD CAUSE BUYER TO LOSE BUYER'S HOME, EVEN IN THE <br /> EVENT OF DEFAULT. SELLER MAY RETAIN A LIEN 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 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 NAVE BEEN ORALLY ADVISED THAT I MAY CANCEI THIS AGREEMENT AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE Of <br /> 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 wit�o (2) copies of t Notice of Right to Cancel Form. <br /> IN WITNESS WHEREOF, this Ins[allment Sales Contract and Mortgage has been signed on this �'� day of �"'vf��� , 19 �� <br /> BUYER'S ADDRESS" � < < �� < <�� ��` City �✓�� f-J/U�� Cou�ty �� �� <br /> Telephone No. �.��1 30 t � cPU�� State 'T E Zip U( <br /> 1 ^ <br /> o !;--�-�z;E',�-� � q�'�� <br /> THE PACESETTER CORPORATION �sE�LeR—Mo►zTCncEE> <br /> BUYER—MORTGAGOR <br /> By: ,�, �a�o%y k. ��'6�r <br /> B .��'.//�/V(AUTHOR C��` B�UYER-MORTG OR—PRI TED NAME <br /> �% 1 <br /> Y� <br /> (FACTORY REPRESENTATIVE) CO-BU ER GOR <br /> �a C�/,�/tc. ���.� <br /> CO-BUYER-MORT AGOR—PRINTED NAME <br /> �0�9 sM-ioi-rrE-Hi�c PncE z ORIGINAL FINANCIAL INSTITUTION <br /> __ . _ —__ _ _ – ___ __—_ _ <br /> - --� <br />
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