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Disclosure Statement And Note
DISCLOSURE STATEMENT AND NOTE-FEDERAL TRUTH IN LENDING ACT
Date: [Date of agreement]
Amount: [Amount of note]
FOR VALUE RECEIVED, the borrower, [name of borrower] residing at [address of borrower], shall pay to the order of [name of creditor], the total amount of $[amount to pay] dollars in consecutive payments payable on the [day of the month] day of the month, beginning on [Date to begin payments], until the loan is paid in full.
Failure to make a payment when due shall be a default of the loan. Should a default exist for more than [Grace period in days] days, the holder of this note may cause the entire loan to be due immediately.
1. Amount of Loan: [Amount of Loan]
2. Expenses: [Expenses]
3. Total Financed: [Total Financed]
4. Interest Charges: [Interest Charges]
5. Total of Payments: [Total of Payments]
6. Annual Financed Percentage Rate: [Annual Financed Percentage Rate]