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FOR USE IN THE STATE OF NEBRASKA PAGE 2 OF 4
<br />SALES
<br />�_ ,INSTALLMENT SALES CONTRACT AND' MORTGAGE CONTRACT NO. 139096
<br />f 177 7,p
<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 1. I agree to pay you the Amount Financed and the Finance Charge in accordance with
<br />the payment schedule below.
<br />f v�o /<«
<br />SUMMARY OF SALE: Base cash price $ S/ , . + tax �% , --" = $
<br />Total cash price $ _ r5 5",Q , O a - Cash [total] down payment $ /00 , e,O = Unpaid balance of $ _�s�_S"� . Oct
<br />ITEMIZATION OF THE AMOUNT FINANCED OF $ 5:C 70 . a 0 .
<br />$ -Sy✓�O • oo Amount credited to this Contract (Same amount as the "Unpaid Balance. ")
<br />$ 470 Amount paid on net balance from prior contract with you. (e)
<br />Amount(s) paid to others on my behalf:
<br />200310781
<br />$ [9 A • Aa to insurance company for Credit Life insurance $ r-?40 • �' d to public officials for filing /recording fees (e)
<br />$ CLO ' [p O to insurance company for Accident and Health insurance $ 757,0 a ® to (Specify) I-% Alf S&" ` 4e�
<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 />©� c
<br />payment of $ o
<br />yearly rate.
<br />I want credit accident
<br />& Health
<br />/a• 0.1 %
<br />1 $ 4? 4, , .2 -0
<br />1 $ J'lf'7©
<br />$ %
<br />$ �753�'. ao
<br />My payment schedule will be:
<br />Number of Payments I Amount of Payments I When Payments are Due
<br />I st Payment Is , ,., ,, 4 ,,, I e First Payment Due X -1G - ©3
<br />g $ ��� rJ 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 />T mrn?
<br />Signature
<br />Credit Life
<br />I want credit life
<br />$
<br />insurance.
<br />nature-
<br />®
<br />00 •c,,,
<br />c7
<br />Signature - Co -Buyer
<br />Credit Accident
<br />I want credit accident
<br />& Health
<br />$/�
<br />and health insurance.
<br />400. pp
<br />C) 0
<br />1 Signature - Buyer
<br />Security: 1 am giving you:
<br />(a) a se y interest in the goods, (Products) being
<br />purchas d, d (b) if, and only if initialed here
<br />® b Buyer 01 Co -Buyer
<br />VVF
<br />a Mortgage n my real estate ai my ` ADDRESS" below.
<br />Filing/Recording fees $ J�l • r) 0
<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 />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: 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
<br />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
<br />you authority to obtain and insert the legal description of my real estate hereon at a later time.
<br />SELLER WILL NOT 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 Contract, 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 COIF IF I CONTAINS BLANK SPACES. 2. YOU ARE ENTITLED TO A COPY OF THE CONTRACT YOU SIGNED.
<br />3. YOU MAY PAY OFF THE F L' ~. DER T C TRACT AT ANY TIME, AND IN SO DOING YOU MAY BE ENTITLED TO A REBATE OF THE UNEARNED
<br />FINANCE AND INSURANCE ARBRIE �. ENT 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 THIST i!ISACTION {a NAI{ COMPANYING NOTICE OF RIGHT TO CANCEL FORM FOR AN EXPLANATION OF THIS RIGHT.)
<br />COPY RECEIVED: I acknowledge receipt of a co etel filled in copy of this Contract along with two (2) cries of the Notice of Right to Cancel Form.
<br />r. p c
<br />IN WITNESS WHEkOf*ttiis Installment dales �onCf d Mortgage has been signed on this 10, day of v o�Ct
<br />BUYER'S "ADI I ?. y - ( < -" :tL�G t 11 City tp _, ,, County /7/, !/
<br />Telephone No. �� St�te / �� Zip
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<br />THE PACESETTER CORPORATION (SELLER- MORTGAGEE)
<br />By:
<br />( HORqw OFFICER)
<br />By:
<br />(FACT911fY REPRESENTATIVE)
<br />L:U-BU Y_hK --MUKI (,710UK ll�l �/yJ
<br />CO- YER- MORTGAGOR - PRINTED NAfAE
<br />7039 SM- 101- NE -IAI PACE ORIGINAL FINANCIAL INSTITUTION
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