Date: ..............
(date on which notice sent or remitted)
..............
(name of merchant)
.............. ..............
(telephone number of merchant)
..............
(address of merchant)
hereinafter called the merchant notifies
..............
(name of consumer)
..............
..............
(address of consumer)
hereinafter called the consumer,
that he is in default to perform his obligation in accordance with the contract
(No. ..............) made between them
(number of the contract if indicated)
at .............. on .............. and that the
(place where the contract was made) (date when the contract was made)
following payment(s) is(are) due:
$.............. on ..............
(amount of payment) (date on which the payment is due)
$.............. on ..............
(amount of payment) (date on which the payment is due)
for a total amount of $ .............. at this date.
(amount due)
The consumer may, within 30 days after receipt of this notice,
(a) remedy the default by paying the amount due at this date, or
(b) return the goods to the merchant.
If the consumer has not remedied the default or has not returned the goods to the merchant at ..............
..............
(address)
within 30 days after the receipt of this notice, the merchant will exercise his right of repossession by having the goods seized, at the consumer’s expense.
If the consumer has already paid one-half of the amount of the total obligation and of the down-payment, the merchant will not be entitled to exercise his right of repossession unless he obtains the permission of the court.
In the case of voluntary return of forced repossession following this notice, the contractual obligation of the consumer is extinguished and the merchant is not bound to return the amount of the payments already received.
The consumer is advised to examine his contract and, if further information is necessary, to contact the Office de la protection du consommateur.
..............
(name of the merchant)
..............
(signature of the merchant)