What is this Repayment for? What is this Repayment for? an Outstanding Balance (debt)GoodsServiceMotor VehicleRent (landlord)Other Enter Amount Owed $ This is the amount owed at the time of writing this Agreement. If the Debtor is repaying a discounted amount, it can be entered later. Describe the Goods: Describe the Services: Other (describe): The OWED RENT is for the Period of: Start Date End Date Vehicle Details Make Model Body Type Year Color Do you know the VIN? Do you know the VIN? YesNo Vehicle Identification Number (VIN) is comprised of 17-characters. Enter VIN: Debtor's Name Name of the party agreeing to the repayment. Do you want to enter the DEBTOR'S Mailing Address? Do you want to enter the DEBTOR'S Mailing Address? Yes (recommended)No Debtor's Mailing Address Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Creditor's Name The party being repaid. Do you want to enter the Creditor's Mailing Address? Do you want to enter the Creditor's Mailing Address? Yes (recommended)No Creditor's Mailing Address Street Address Address Line 2 City Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming State ZIP Code Will there be a DISCOUNTED AMOUNT if the Debtor makes all their payments on time? Will there be a DISCOUNTED AMOUNT if the Debtor makes all their payments on time? YesNo It is common to include a discounted amount as an incentive if the Debtor makes all their payments on time. If the Debtor fails to make any of the payments on time, the balance will be the original amount (less any payments made). Enter the DISCOUNTED AMOUNT: $ Is there a DOWNPAYMENT as part of this repayment? Is there a DOWNPAYMENT as part of this repayment? Yes (recommended)No Downpayment Amount $ Will there be INTEREST (%) charged as part of this repayment plan? Will there be INTEREST (%) charged as part of this repayment plan? YesNo Interest Rate (%) % Payments are due: Payments are due: on a Monthly basison a Bi-Weekly basis (2 weeks)on a Weekly basisOther 1st Payment Due Last Payment Due Payment is Due on the 1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th15th16th17th18th19th20th21st22nd23rd24th25th26th27th28th29th30thof each month Payment is due on the MondayTuesdayWednesdayThursdayFridaySaturdaySundayof each week Explain the Repayment Period: Payment Instructions Do You Wish To Specify the Exact Amount Due Each Installment? Do You Wish To Specify the Exact Amount Due Each Installment? YesNo If no, the form will state all payments due are "equal installments." This means the amount due on the specified basis will be a number that is equal to the total debt divided by the total number of payments. Enter the Amount Due Each Installment $ Enter the dollar amount due at each installment period. Will there be Specific Payment Instructions? Will there be Specific Payment Instructions? YesNo Such as the Debtor being required to pay via direct (ACH). Enter the Payment Instructions: The Debtor is required to make automatic payments via ACH. Are LATE PAYMENTS to be accepted under this Agreement? Are LATE PAYMENTS to be accepted under this Agreement? Yes, but with a Late FeeNo The Debtor can be up to: Day(s) Late Enter the Late Fee: Will there be a PRE-PAYMENT PENALTY? Will there be a PRE-PAYMENT PENALTY? YesNo Some Creditors will require a pre-payment penalty to ensure some kind of return on the borrowed money. Enter the Pre-Payment Penalty: Which State will govern this Agreement? Please SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming Commonly the State where the Debtor resides. Will there be a Co-Signer under this Agreement? Will there be a Co-Signer under this Agreement? YesNo A Co-Signer, also known as a "Guarantor", allows someone else to be liable in case the Debtor does not pay. The Co-Signer would have the same liability and obligation to pay as the Debtor. How Many Co-Signers? Choose12 Co-Signer's Name 2nd Co-Signer's Name The 1st and 2nd Co-Signer have equal liability if the Debtor does not pay. Any Additional Terms or Conditions? Any Additional Terms or Conditions? YesNo Enter Additional Terms & Conditions: Date of this Agreement The date this Agreement is written. Usually today's date. Next Save Save and finish later
