PAYDAY LOAN CONTRACT AND DISCLOSURE STATEMENT Lender: Johnson's Title & Payday Loan 123 Anywhere Street Chicago, Illinois

Similar documents
PAYDAY LOAN CONTRACT AND DISCLOSURE STATEMENT Lender: Johnson's Title & Payday Loan 123 Anywhere Street Chicago, Illinois

Private Party Purchase Cover Sheet

On-Bill Financing Agreement

CTA ARCHITECTS ENGINEERS 401(K) RETIREMENT PLAN PARTICIPANT LOAN PROGRAM

LOAN REPAYMENT AGREEMENT

FORM OF LETTER OF AGREEMENT [Letterhead of the Borrower]

Enclosed is a False Certification (Ability to Benefit) Loan Discharge Application. Please read all the instructions before completing the form.

TITLE LOAN AGREEMENT

DECLARATIONS FOR REAFFIRMATION REQUIRED BY CODE 524(k)

INSTRUCTIONS ON COMPLETING A LLU PROMISSORY NOTE

Health Professions Student Loan Application

Sokaogon Chippewa Community Ordinances

Discount Window Lending Agreement Instructions

Varies by State from 17% to 23%.

TENNESSEE: ADVANCE FEE AGREEMENT

Administrator - Uniform Consumer Credit Code and Commission on Consumer Credit

City of Bishop Commercial Façade Improvement Revolving Loan Fund Program Description and Conditions

MCC COUNTY ACQUISITION LIMITS FOR NEW CONSTRUCTION AND EXISTING PROPERTIES: TARGETED AREAS: $289,705 NON-TARGETED AREAS: $237,031

PAL ReFi Loan. Why refinance? What are the repayment options? When is my first monthly payment due? What are the eligibility requirements?

Annex I Specimen Subordinated Loan Agreement

VISA CREDIT CARD APPLICATION AGREEMENT & TRUTH-IN-LENDING DISCLOSURE STATEMENT

ISSUING REGISTERED WARRANTS Policy 522

CONTRACT REQUEST FORM

Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship:

WAGE WITHHOLDING FOR DEFAULTED STUDENT LOANS A HANDBOOK FOR EMPLOYERS. Revised June 30, 2008

WAGE PAYMENT AND COLLECTION LAW Act of Jul. 14, 1961, P.L. 637, No. 329 AN ACT Relating to the payment of wages or compensation for labor or

Document Checklist for 203k Loans

BECK EQUIPMENT, INC Preble Rd, Preble, NY Toll Free: (866) / Fax: (607)

STANDARD CONTRACT EXECUTION FORMS

PROMISSORY NOTE. Bellingham Resale Restricted Downpayment

REQUEST FOR PROPOSAL FOR RISK MANAGEMENT CONSULTANT

00396E (06-12) MGA - Associate Broker

PACE OWNER CONTRACT RECITALS

The Promissory Note. Questions

Application/Change Form For Individual Dental Insurance

PREVIEW PLEASE DO NOT COPY THIS DOCUMENT THANK YOU. LegalFormsForTexas.Com

DEBIT AUTHORIZATION (FreedomCashLenders)

REVENUE LOAN AGREEMENT (Promissory Note) Date of Loan: Payment Start Date: Lenders, or Investors means all of the purchasers of the Notes.

AGREEMENT AND FEDERAL TRUTH-IN-LENDING

DEED OF APPOINTMENT & ASSIGNMENT BUSINESS TRUST

PROMISSORY NOTE TERM TABLE. BORROWER S PRINCIPAL (manager):

AML training was completed through LIMRA on: AML training was completed throughan independent program on: / / (Certificate Attached)

NGL Contracting Checklist

CONSUMER CREDIT CARD AGREEMENT

State Bank Commissioner Consumer and Mortgage Lending Division

EL PASO COUNTY PACE LENDER CONTRACT

11.00% to 18.00% when you open your account, based on your % to 18.00% when you open your account, based on

QUALIFIED ANNUITY CONTRACT LOAN APPLICATION AND AGREEMENT

DEED OF TRUST WITH REQUEST FOR NOTICE

APPLICATION FOR PARTICIPANT LOAN

REQUEST for CONTACT INFORMATION

Saint Vincent de Paul Parish School Student Tuition Contract School Year

AUTHORIZATION AND PAYMENT

Tax Services. To see if you qualify for these products, you agree to do the following steps

Loan Request, Points to Consider and Loan Policies & Procedures

TITLE CLOSER AFFIDAVIT TRUST

INITIATIVE PETITION TITLE. Short-Term Loan Consumer Protection Amendment SUMMARY

The Cost of Credit Disclosure Act

MORTGAGE. After Recording Return To: [Space Above This Line For Recording Data] WORDS USED OFTEN IN THIS DOCUMENT

HOME EQUITY CONSUMER LOAN APPLICATION

Electronic Funds Transfer, Credit Card Payments, and Electronic Filing.

BECK AUTO SALES, INC. 401(K) PLAN. SAFE HARBOR NOTIFICATION TO ELIGIBLE EMPLOYEES (includes Automatic Contribution Arrangement)

THE MISSISSIPPI UNITED METHODIST FOUNDATION, INC. INVESTMENT CUSTODIAL AGREEMENT

Kansas Credit Services Organization Instructions for Application of Registration

1. Last Name First Name MI. State # 8. Lender Name City State Zip Code

No AN ACT. The General Assembly, of the Commonwealth of Pennsylvania hereby enacts as follows:

SECURITY DEED MODIFICATION AGREEMENT

Terms and Conditions of Title IV, HEA Loans

CLASS ACTION CLAIM FORM

Private Education Loan Application and Solicitation Disclosure Page 1 of 2

CIRCUIT COURT OF ILLINOIS. Sixth Judicial Circuit Champaign County

Teachers Federal Credit Union Mortgage Loan Disclosure for Adjustable Rate Mortgage

THE PEOPLES BANK OF MULLENS MAKING CHANGES HAPPEN

City of Chicago Department of Planning and Development TAXSMART MORTGAGE CREDIT CERTIFICATE PROGRAM SERIES Section Three - Borrower Application

DEED OF TRUST NOTICE: THIS LOAN IS NOT ASSUMABLE WITHOUT THE APPROVAL OF THE DEPARTMENT OF VETERANS AFFAIRS OR ITS AUTHORIZED AGENT.

TITLE 10. DEPARTMENT OF BUSINESS OVERSIGHT

Extreme Visa 1.99% 15.90% Visa Secured 15.90% Extreme Visa. your creditworthiness. Visa Secured. Extreme Visa. your creditworthiness.

Created by Neevia docuprinter LT trial version

Member Name QILDRO Page 1 of 5

Illinois Compiled Statutes Business Transactions Retail Installment Sales Act 815 ILCS 405/

After that, your APR will be 12.40% to 21.40%, based on your. Visa Platinum N/A. Visa Platinum Variable. Visa Platinum.

LOAN ORIGINATOR APPLICATION INSTRUCTIONS

CONSUMER CREDIT CARD AGREEMENT AND DISCLOSURE

TOWNSHIP OF RARITAN REQUEST FOR QUALIFICATIONS RISK MANAGEMENT CONSULTANT SUBMISSION DEADLINE AT WHICH TIME PROPOSALS WILL BE OPENED IS

ACCOUNT AGREEMENT & DISCLOSURES. Effective September 30, 2017

504 Repair Loan Pre Qualification Worksheet

APPLICATION AND SOLICITATION DISCLOSURE

AGREEMENT AND FEE FORMS

State of Texas Department of Transportation Electronic Lien and Title Program Service Level Agreement

Promissory Note Education Loan

CHICAGO REGIONAL COUNCIL OF CARPENTERS WELFARE FUND REIMBURSEMENT AGREEMENT FOR THIRD-PARTY CAUSATION

CHANGE REQUEST: TRUST CERTIFICATION

Is Applicant actively engaged in a futures business? No Yes Is Applicant registered with NFA?

UNITED STATES DEPARTMENT OF AGRICULTURE RURAL DEVELOPMENT RURAL HOUSING SERVICE REQUEST FOR SINGLE FAMILY HOUSING LOAN GUARANTEE

SECTION 9 OTHER DEDUCTIONS FROM PAY

Receipt Date. You must answer all questions in ink and the application must be signed and notarized, or it will be rejected.

203(K) STANDARD OWNER/CONTRACTOR AGREEMENT

SEVENTH AMENDED AND RESTATED SECURED PROMISSORY NOTE. (For Revolving Line of Credit, Advances and Guaranteed Obligations)

County: State: ZIP: Address: Billing Address for Premium Notices (complete only if different from above).

LICENSED LOAN ORIGINATOR AGREEMENT

Transcription:

: PAYDAY LOAN CONTRACT AND DISCLOSURE STATEMENT Lender: Johnson's Title & Payday Loan 123 Anywhere Street Chicago, Illinois 60016 456-789-4568 4/12/2006 Loan Number CA100 Maturity : 4/26/2006 Borrower: RON JOHNSON Address: 600 W QUEEN STREET City, State, Zip: HAMPTON, VA 23669- FEDERAL TRUTH-IN-LENDING DISCLOSURE STATEMENT ANNUAL PERCENTAGE RATE The cost of your credit as a yearly rate 391.07% FINANCE CHARGE The dollar amount the credit will cost you $30.00 AMOUNT FINANCED The amount of credit provided to you or on your behalf $200.00 TOTAL OF PAYMENTS The amount you will have paid after all scheduled payments are made $230.00 ITEMIZATION OF AMOUNT FINANCED Amount Given Directly to you: $200.00 2. Amount Paid on Previous Loan with us: $0.00 Security * Your post-dated check(s) and/or Automated Clearing House Authorization ( ACHA ) which if so attached, is/are made part of this Agreement, as though fully stated herein is security for the loan. * Your wage assignment, if given, is also security for this loan. PAYMENT SCHEDULE Your payment schedule will be: Number of Payments Amount of Payment When Payment is Due 1 $230.00 4/26/2006 Prepayment A Consumer may cancel future payment obligations on a payday loan, without cost or finance charges, no later than the end of the second business day, immediately following the day on which the payday loan was executed. If you pay off early, you will not be entitled to a refund of a portion of the finance charge. See below and and/or second page of this contract for any additional information about nonpayment, default, any required payment in full before the scheduled date, and prepayment refunds and penalties. By signing this Loan Contract and Disclosure Statement (this contract ) and accepting a loan from Johnson's Title & Payday Loan (''Lender'') the undersigned borrower (''I'', ''you'', ''borrower'') agrees to and accept the terms and conditions set forth on all pages of this contract. I UNDERSTAND THAT IF I STILL OWE ON ONE OR MORE PAYDAY LOANS AFTER 35 DAYS, I AM ENTITLED TO ENTER INTO A REPAYMENT PLAN THAT WILL GIVE ME AT LEAST 55 DAYS TO REPAY THE LOAN IN INSTALLMENTS WITH NO ADDITIONAL FINANCE CHARGES, INTEREST, FEES, OR OTHER CHARGES OF ANY KIND. WARNING: THIS LOAN IS NOT INTENDED TO MEET LONG-TERM FINANCIAL NEEDS. THIS LOAN SHOULD ONLY BE USED TO MEET SHORT-TERM CASH NEEDS. THE COST OF YOUR LOAN MAY BE HIGHER THAN LOANS OFFERED BY OTHER LENDING INSTITUTIONS. THIS LOAN IS REGULATED BY THE DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION. YOU CANNOT BE PROSECUTED IN CRIMINAL COURT TO COLLECT THIS LOAN. Signature of Borrower Lender: Johnson's Title & Payday Loan, by its duly authori Name: Title: Notice: See other side for important information

Assignor s (Employee/Borrower) Name And Address: RON JOHNSON 600 W QUEEN STREET HAMPTON, VA 23669- WAGE ASSIGNMENT Employer Name And Address: LIVEOPS 3340 HILLVIEW AVE PALO ALTO, CA 94304- Assignor's Social Security Number: 226-08-9406 Loan Number: CA100 of Loan 4/12/2006 Maturity : 4/26/2006 FEDERAL TRUTH IN LENDING DISCLOSURE STATEMENT ANNUAL PERCENTAGE RATE The cost of your credit as a yearly rate. FINANCE CHARGE AMOUNT FINANCED TOTAL OF PAYMENTS The dollar amount the credit will cost you. 391.07% $30.00 Your Payment Schedule is: One payment of $230.00 due on 4/26/2006 The amount of credit provided to you or on your behalf The amount you will have paid after you have made all payments as scheduled. $200.00 $230.00 This Wage Assignment is being executed by me ( Assignor ) to secure the above-referenced loan given to me by Johnson's Title & Payday Loan ( Assignee ). If, 40 days after the Payment Due, I am in default under the terms of my loan agreement, Assignee will have the right, pursuant to and in accordance with the Illinois Wage Assignment Act, 740 ILCS 170/.01 et seq., to collect the amount due from my present employer or a future employer. I understand that I may revoke this assignment of wages at will by written notice to Assignee. The maximum wages, salary, commissions and bonuses that may be collected by Assignee herein for any work week shall not exceed the lesser of (1) 15% of such gross amount paid for that week or (2) the amount by which disposable earnings for a week exceed 45 times the Federal Minimum Hourly Wage prescribed by Section 206(a)(1) of Title 29, U.S.C., as amended, or the minimum hourly wage prescribed by Section 4 of the Minimum Wage Law (820 ILCS 105/1 et seq.) whichever is greater, in effect at the time the amounts are payable. The term "disposable earnings means: that part of the earnings remaining after the deduction from those earnings of any amounts required by law to be withheld. I hereby authorize, empower and direct my employer to pay to Assignee any and all monies due or to become due me hereon, authorize Assignee to receive the same, and release and discharge employer from all liability to me on account of monies paid in accordance herein. No copy of the Wage Assignment shall be served on employer except in conformity with applicable law. I acknowledge receipt of an exact copy of this Wage Assignment. WITNESS: WAGE ASSIGNMENT ASSIGNOR: (Assignor has received an exact copy of this Wage Assignment) :

Loan Number: CA100 ACKNOWLEDGEMENT RECEIPT OF CONSUMER NOTICE REPORTING OF CREDIT TO A CONSUMER REPORTING AGENCY This shall acknowledge that on the date listed below, that I, RON JOHNSON, have received from Johnson's Title & Payday Loan a copy of the CONSUMER NOTICE REPORTING OF CREDIT, indicating that negative credit information related to the Loan Number stated above may be reported to a credit bureau. (Signature of Borrower) ()

Loan Number: CA100 OPTIONAL PRE-AUTHORIZATION TO ELECTRONIC FUND TRANSFER On the date written below I have entered into an installment loan agreement with Johnson's Title & Payday Loan ( Lender ), whereby Lender has agreed to lend me a certain amount of money, as set forth in the Installment Note and Disclosure Statement ( Agreement ) signed by me and dated as of today s date. In connection with this loan, I have provided Lender with a voided check from my bank account. I hereby authorize the Lender to either: (a) electronically debit, or (b) issue a bank draft against, my bank account number 111222333 at First Tennessee Bank in the amount the installment payment (s), provided for by the Agreement on the due date of said installment(s). Furthermore, in the event that I am in default under the Agreement, as that term is defined in the Agreement, I hereby authorize Lender to either: (a) electronically debit, or (b) issue a bank draft against, my bank account number 111222333 at First Tennessee Bank in the amount of the past due installment payment(s), or a potion thereof up to the outstanding past due balance as of the date of default. I CAN REVOKE THIS AUTHORIZATION BY GIVING NOTICE OF REVOCATION TO LENDER. ANY REVOCATION IS EFFECTIVE ONLY AFTER LENDER HAS RECEIVED WRITTEN NOTICE FROM ME TO REVOKE THIS AUTHORIZATION IN SUCH TIME AND MANNER AS TO AFFORD A REASONABLE OPPORTUNITY TO ACT UPON THE NOTICE. I ALSO HAVE THE RIGHT TO STOP PAYMENT OF THE DEBIT ENTRY BY NOTIFICATION TO MY BANK AT LEAST THREE BUSINESS DAYS BEFORE THE SCHEDULED DATE OF THE ENTRY. I acknowledge that I have read and understand this pre-authorization form and that I am entitled to a copy of it. Signature of Borrower

Loan Number: CA100 REPAYMENT PLAN ACKNOWLEDGEMENT I UNDERSTAND THAT IF I STILL OWE ON ONE OR MORE PAYDAY LOANS AFTER 35 DAYS, I AM ENTITLED TO ENTER INTO A REPAYMENT PLAN THAT WILL GIVE ME AT LEAST 55 DAYS TO REPAY THE LOAN IN STALLMENTS WITH NO ADDITIONAL FINANCE CHARGES, INTEREST, FEES, OR OTHER CHARGES OF ANY KIND. Borrower's Signature