Page 1 of 1 ura Udis - Proposed Administrative Rules "Janice Clark” "Laura Lie 8272010 10:54 AM Proposed Administrative Rules Attachments: Sample Liselosure Statement, Itemizaton, Promissory Note and Security ‘Agreement pf ‘CONFIDENTIALITY NOTICE: THIS EMAIL MESSAGE AND ANY ATTACHMENTS ARE INTENDED ONLY FOR THE PRIVATE REVIEW AND USE OF THE INDIVIDUAL OR ENTITY TO WHICH THIS MESSAGE IS. ADDRESSED. IN ADDITICN, THIS MESSAGE AND THE ATTACHMENTS, I ANY, MAY CONTAIN ATTORNEY. CLIENT PRIVLEGED CONMUNICATIONS WHICH ARE EXEMPT FROM DISCLOSURE UNDER ‘APPLICABLE LAW. Ifthe eader ofthis note not he intended reciplent or the employee or agent vesponsble for delivering this message b the nlended recipient, you are hereby notified that any review, dissemination, adore, reptoducbon, éeibuton. copying oF other uso of ary porton of the felowing message and ary ‘Stachments tne prohies. Delivery of he mostago any person otha fran to ntonded repent fot Intendes to waive any ng o prviege Ifyou Beteve tat You have resolved this message i ear, please not {Us prompily by repty Emal, immediatly delete his message permanently fm your system. Thank You. (Dear Lauta: In accordance with our conversation, ltached is 9 copy of the sample dlered depositican Dielosute Statoment,lemirator, Promissory Note ana Secury Agreement references in our August 23, 2010, later regarding the Proposes Admiistave Rules. Regards, Jan Clank sanice Hofmann Clark Helersteh ana Store. PC ‘5847 8. Valenta Way, Sute 100 ‘Greenwood Vilage, CO 80111 Phone: 308 573.1080, x80 Fax: 3085711271 Ema: ark@shoreatys com file:/(C\Documents and Settings\Ueudisle\ocal Setting\Temp\XPyrpuise\4C779970CO.... 8/27/2010DISCLOSURE STATENENT, ITEMIZATION, PROMISSORY NOTE AND SECURITY AGREEMENT (Oeterted Doposit Loan) ewer ANNUAL, FINANCE ‘Amount Financed Teal ot Payments PERCENTAGERATE | CHARGE ‘rma costotmy crctesa | Thealaramounttne reat | grovanstore oronmy | wen have mace a year ss cotme Sorat ‘Bled samen Ty paersehesoe abe anberofPaymeris | AnourolPaynents | iter Payments he Doe ‘te day of aah mor bapaneg_—_———— ‘eau Ths an @eearedty acorn Hiovesin Ch ny pected Sects Cimy ACW auhrizatons_Wottd below Propaymant pa of eat, wl othave to pay 2 pena, my be ena to ein ato the fnanca charge. | oudee my ceil doeunate fr any adda infomation tou ngayon equa payment hbase Faance Chagas SY Iemaaton ofthe Arun Fnand of $ Amour gen be deaty e Interest 45% pr enna = ‘our pad on my cre 5 Ongnaten Foe 5 Nonny Maintarance Fees [IMPORTANT NOTICES REQUIRED BY COLORADO LAW. "A DEFERRED DEPOSIT LOAN IS NOT INTENDED TO MEET LONG TERM FINANCIAL NEEDS. A DEFERRED DEPOSIT LOAN SHOULD BE USED ONLY TO MEET SHORT TERM CASH NEEDS, RENEWING ‘THE DEFERRED DEPOSIT LOAN RATHER THAN PAYING THE DEBT IN FULL WILL REQUIRE ADDITIONAL, FINANCE CHARGES, ‘STATE LAW PROHIBITS DEFERRED DEPOSIT LOANS EXCEEDING FIVE HUNDRED DOLLARS ($500) TOTAL DEBT PLUS APPLICABLE FINANCE CHARGES PERMITTED BY LAW FROM A DEFERRED DEPOSIT LENDER. EXCEEDING THIS AMOUNT MAY CREATE FINANCIAL HARDSHIPS FOR YOU AND YOUR FAMILY. ‘YOU HAVE THE RIGHT TO RESCIND THIS TRANSACTION BY § PM. THE NEXT BUSINESS DAY FOLLOWING ‘THIS TRANSACTION, 1 Bavewers hing onder taflovingpostdaed chats 1 Soroneri ing Lend the folowing ACH ‘secure a suerstons a stay ors ar ‘Caeachia | Arountoferwk | Oat of Check mount ot ACH Date of Anata = ras 5 5 § 5 s s s § eee £ Page tof?PROMISSORY NOTE AND SECURITY AGREEMENT FOR VALUE RECEIVED, the indersigred (Soriomer of"), jolly and severly # mexe then ene, promis to pay to Lender, te address, ho Amount Financed plus eearet at the rato 45% per orn unl he Neto fe po nhl {ogether wth tbe Onginaon Fos and Mehl Maintenance Fees in acsordance th tePaymen Schad. all as shown ‘onthe reverse sie of his Promissory Nae ana Secury Agreement. The amount of each payment must be pain fll, before 3 P.M local tine onthe payment cue dae, Payment when made wil be appied fst oltses. then 10 Te Origination Fee, hen to any Mecthly Mantonence Fee the duo, andthe balance to pra Borrower agrees tat any payment raquiedby this Nteis ropa when tiscue, Borrower wil bein faut. Borrower isin defaut subject to Borovers nh to cure If any, Lender may dere the entre unpaid talace of ths Note immediately dve and payable in ful ln the evant of taut, Borower agrees to pay Langer court costs and te reasonable storey’ fee incurred. not excens othe Amount Financed, ar sarded bya coun ‘As sacury fr he poyrrent ofthis Noe, Berower gives Lender a secuty interestin and possession of Borower' post: dated checks o AGH suthotzstionsldrafed one verse side ofthis page. Borowsr agrees tht Lender may use Borrowers pest-daied checks ACH authorizations to ebain payment ofthe amounts owed by Borowero Lender under the terms of ts Note when due PLEASENOTE: Thepost-datt checks or ACH authorzations vento Lender as secuy forthe payment this Note are ‘namours which are ess thanthe merhly payers due under this Note, On each payment due date, Borower must ‘ther (1) pay Lender the flaunt ofthe rently paymect. tn woich event Lender wil not ub Borrower's posaated Check or ACH authorization fer payment © (2) pay Lander the difrence between the aunt of Borewar’s potato’ ‘heck or ACH autharzaton andthe amount of the payment whichis dus, m whch event Lander wl submit Borrowers Dostdaed check or ACH authotzation to obtain payment ofthe balance ef the monihy payment orromormay prepay this Not at ary te wthout perlly. Borrower maybe antitdtoarelundf potion of hsinarest component of he fence charje upon prepayment in fl. Ary refund oF a pean of the irerest wil be clelted it ‘Secardance wit prorat mated as provided by Colorado law. Borower ages 0 pay Lender arelumed check charge {91826 00 one of Borrowers pet dated checks or ACH auorizatons felines uroadby the bark nich kis drawn fovinsuffeent nds or ahense Borrower represents and warais to Lender statements made in Borrower's most cent ret application main ‘nue, complete and caret asc the dae ofthis Note. Presentinent oc payment protest, noise ot nonpayment and of Drolet ore waived. Borrower eoraes Lender may delay or forgo enforcing any off ghs without losing any cf therm This Note shall te governed by and construed n accordance wih federal and Colorado law. TTonderstand tht iam marie, | may requost a soparai,indidual loan ia my own name fal Lenders ced Standards | may obtain sont lean wih any cer person. | acknowedge and apre that ts my voluntary decison ‘whether fo obtain a indvdualan, or aint ean wih another person. Inia the appropeate ine: I want toobtan an nividual ean ny name ony —Iwantto btan ant ioan wih he cotborrower {8 sgring balay, Borawar acknowledges that Borower has read, understands and agrees fo al ofthe fom and {anatons ch both sides of ths page. Sorower also acknowledges comp ota fll completed copy offs Disclosure ‘Statement, temaaton of Amovn! narced. Promistory Note and Secutty Agreement Bowrowers signature: Co-Borrower’ signature: Dale Dale Lander ey Tan Oar Dae