Date: ............................................................................ (date on which contract is entered into) |
Place: ............................................................................. (place where contract is entered into) |
.................................................................................... (name of merchant) |
.................................................................................... |
.................................................................................... (address of merchant) |
.................................................................................... (where applicable, technological address of merchant) |
.................................................................................... (Where applicable, the merchant’s permit number) |
.................................................................................... (name of consumer) |
.................................................................................... |
.................................................................................... (address of consumer) |
Description of the object of the contract .................................................... |
1. | (a) Cash sale price of the goods or service | $........... | |
(b) Installation, delivery and other costs | $........... | ||
2. | (a) Total cash price | $=========== | |
(b) Cash payment | $........... | ||
3. | (a) Balance — Net capital | $=========== | |
(b) Interest | $........... | ||
(c) Other components of the credit charges | $........... | ||
4. | Total of credit charges for the term of the contract | $=========== | |
5. | Consumer’s total obligation | ||
Credit rate | ........... % | ||
The term of this contract is ……………………………………… | |||
Date on which the credit charges begin to accrue (or how that date is determined): ……………………………………………………………………………….. | |||
The consumer’s total obligation is payable at ............. (address) in .............. deferred payments of $.............. on .............. day (number) of each consecutive month as of ............. (due date of the first payment) and a final payment of $.............. on ............. (due date of the last payment). | |||
(Where applicable, mention the nature of any optional contracts, the charge for such contracts, or how it is determined and that the consumer has a right of resiliation with respect to such contracts.) | |||
(Where applicable, mention the existence and the subject matter of any security given by the consumer to guarantee the performance of the consumer’s obligations.) | |||
The merchant performs the merchant’s principal obligation when entering into this contract. | |||
⃞ Yes ⃞ No | |||
if “no”, on .............. (date of the performance of the merchant’s principal obligation) |