PROMISSORY
NOTE AND DISCLOSURE STATEMENT
[Federal
Truth in Lending Act]
Date:
FOR VALUE RECEIVED,
the undersigned jointly and severally promise to pay to the order of
[__], the sum of [s-SumCheckAmount] in [s-Number] consecutive,
monthly payments of [s-MonthCheckAmount] each, beginning one month
from date hereof and thereafter on the same date of each subsequent
month until paid in full. Any unpaid balance may be paid at any time
without penalty and any unearned finance charges will be refunded
based on the Rule of 78's. In the event the undersigned defaults in
any payment beyond [s-PayNumber] days from the due date, the entire
balance may be due at the option of the holder.
1. Proceeds $_
2. Other charges
[itemize] $_
3. Amount financed
[1+2] $_
4. Total of
payments $_
5. Annual Percentage
Rate [s-PercNumber]%
_______________________________ ___________________
Signature Date
