Fill and Sign the Note Sale Form

PROMISSORY NOTE (in connection with sale of motor vehicle) ____________________ ______________________________ (Dollar Amount of Note) (City and State where executed) ________________ (Date) FOR VALUE RECEIVED, the undersigned ______________________ (Name of Buyer) does hereby promise to pay to ________________________ (Name of Seller), or order, the principal sum of __________________ (Dollar Amount of Note), together with interest thereon from date at the rate of ______Percent (______%) per annum on the unpaid balance until paid. The said principal and interest shall be payable to Seller at his address of ________________________________________________________ ____________________ (street address, city, county, state, zip code) , or at such other place as the holder hereof may designate in writing, in (number) consecutive monthly installments of _______________ (Dollar Amount). The first of said installments shall be due and payable on the ________________ (date), and each subsequent monthly installment shall be due and payable on the first day of each succeeding month thereafter until the entire indebtedness evidenced by this Note is fully paid, except any remaining indebtedness, if not sooner paid, shall be due and payable on ________________ (date). The undersigned may prepay the principal amount outstanding in whole or in part without penalty. The holder of this Note may require that any partial prepayments (i) be on the date monthly installments are due, and (ii) be in the amount of that part of one or more monthly installments which would be applicable to principal. It is agreed that in the event default is made in the payment of this Note at maturity, or of any installment thereof, whether maturing by expiration of time, by default as herein provided, or as provided in the Security Agreement given in security hereof, and the same is placed in the hands of an attorney for collection, then an additional amount of Ten Percent (10%) on the principal and interest of this Note shall be added to the same as a collection fee, and the failure to pay any installment when due shall mature the entire indebtedness at the option of the holder of this Note. Upon default for ten (10) days, the vehicle sold to Buyer in connection with this promissory note shall be returned to Seller and Seller is granted all rights of repossession as a secured party. This Note is given to secure payment of the remaining purchase price of a Vehicle identified as follows:  New or used: ___________ (state whether new or used) ;  Year and model: ________ (year of Vehicle) and ______________ (model of Vehicle);  Number of cylinders: ______ (number);  Make or trade name: _____________ (make);  Body type: ______________ (body type);  Model number or series: ___________ (number);  Manufacturer's Serial Number: ________________________ (number); Motor Number: ______________ (number). Title to the Vehicle will transferred to Buyer upon execution and delivery of this Note, and Seller does hereby retain a vendor’s lien in said Vehicle. Buyer grants to Seller a security interest in the Vehicle until this Note is paid in full. The makers, signers, drawers, guarantors, sureties and endorsers hereof severally waive presentation for payment, demand, protest, diligence in collecting, notice of dishonor, notice of extension of time, and notice of protest or nonpayment. WITNESS my signature this the ____ day of _______________, 20_____. _________________________ (Printed Name of Buyer) _________________________ (Signature of Buyer)