Promissory Note

Installment Promissory Note with Bank Deposit as Collateral

1. Terms of Note

For value received, and , of , hereinafter jointly called the Makers, promise to pay to the order of , of , hereinafter called the Institution, at the aforementioned address of Institution, the principal sum of $ with interest at % per year, in installments as follows: $ in monthly installments of $ each, beginning on , continuing on the same day of each month, and ending on .

2. Bank Deposit as Collateral

Makers shall furnish collateral security for the indebtedness evidenced by this Note by depositing with Institution on $ for credit to the Personal Loan Account No. , hereinafter called the Personal Loan Account, and an equal amount subsequently is to be deposited at regular monthly intervals, until the total sum equal to the face amount of this Note is deposited.

3. Default in Deposits

If Makers fail to deposit money as agreed in Section 2, Makers shall pay to Institution, as liquidated damages, cents for each dollar not deposited.

4. Personal Loan Account as Payment on Note

When this Note matures, by acceleration or any other manner, Institution may apply the amount on deposit in the Personal Loan Account against the amount owing on this Note. However, Makers shall still be liable for any indebtedness represented by this Note that remains unpaid after this application.

5. Security Interest in other Property of Institution

As security for the payment of this Note and for the payment of all other debt of any of Makers to Institution, including debt of every kind and description, direct or indirect, absolute or contingent, due or to become due, now existing or subsequently arising, and regardless of how the debt is evidenced, Makers grant to Bank a continuing lien on all instruments, documents of title, policies of insurance, deposits, moneys, or any other property now or subsequently owned by any of Makers now or subsequently in the possession or under the control of Institution.

6. Acceleration on Default

This Note shall become immediately due at the option of Institution or other holder of this Note without demand or notice on the occurrence of any of the following events:

A. Failure to deposit the appropriate amount in the personal loan account as specified in Section 2;

B. The death of, dissolution of, or beginning of any action to dissolve any maker or any endorser of this Note;

C. Commencement of any proceeding by or against any maker or any endorser under the federal Bankruptcy Act or any other present or future state or federal insolvency laws;

D. Failure of any maker to furnish on request of Institution additional security satisfactory to Institution for this Note within days after demand by Institution for such additional security; or

E. Failure to pay any other obligation now or subsequently owing to Institution or any other holder of this Note by any maker or by any endorser.

7. Waiver of Presentment, Protest, and Notice of Dishonor

Each Maker and each endorser of this Note waives presentment, protest, and notice of dishonor and any other notice that may be required.

8. Powers of Institution in Dealing with Note

Each Maker and each endorser authorizes Institution to do the following without giving notice and without affecting the liability of any maker or endorser:

A. Date this Note;

B. Fill in any blank spaces in this Note according to the terms on which Institution grants the loan;

C. Correct patent errors;

D. Cause the signature of one or more additional Makers or endorsers to be added to this Note at any time;

E. Extend the time of payment of this Note in whole or in part;

F. Sell, exchange, surrender, or otherwise deal with the property now or subsequently securing this Note; and

G. Assign this Note or any security for this Note to any other person.

9. Governing Law

This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of .

10. Joint and Several Liability

The Makers of this Note shall be jointly and severally liable.

11. Confession of Judgment

Each Maker and each endorser of this Note authorizes any attorney-at-law to appear in any court of record in or any other state or territory of the United States after this Note becomes due, by acceleration, or otherwise, and admit the maturity of this Note, waive the issuing and service of process, and confess judgment against each Maker or endorser in favor of Institution or any other holder of this Note for the amount then appearing due and the costs of collection, including reasonable attorney's fees and legal costs. Each maker and each endorser shall also waive all errors, rights of appeal, and stays of execution. This is a joint and several warrant of attorney.

WITNESS our signatures as of the day and date first above stated.