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Name: JEFF SMITH Street Address: TH 8817 SE 155 PLACE City: SUMMERFIELD State: FL Zip: 34491 Borrower Information: Date: 07-14-2011 Date of Birth 09-18-1970: Area code/Telephone number: 352-454-5000 / 352-454-5239 Drivers License Number: S530422703380 Social Security Number: ***-16-1455
Lender Information: Area code/Telephone number: If paying by check, make check payable to:
Loan Amount:
Payment Schedule:
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1. Promise to Pay. For value received (ONE 1996 VOLVO 850R VIN: _________________________) EXEMPT MILEAGE, JEFF SMITH (Borrower) promises to pay BEN (Lender) $___________ and interest at the yearly rate of ZERO % on the unpaid balance as specified below. 2. Installments. Borrower will pay ______ payments of $200.00 CASH each at month at intervals on the LAST FRIDAY of each month until the note is satisfied. Borrower will pay one lump payment of $1000.00 USD cash on JULY 14 2011 toward the balance of the note. Lender HAS received the initial payment of $1000.00 CASH as described. ___________ (initials). 3. Application of Payments. Payments will be applied to the principal. 4. Prepayment. Borrower may prepay all or any part of the principal without penalty. 5. Security This note is NOT secured by any other means.
6. Warranty.