Promissory Note and Disclosure Statement

This Promissory Note and Disclosure Statement is a great letter to use when entering into a new financial agreement.

Although this isn’t a terribly lengthy document, it won't come up short to your needs.

This form is straight to the point and towards the end it breaks everything down into further, necessary detail.

If you choose to sit down with your payee and review this document, the important specifics are clearly listed!

You can even save a hard copy of this letter and fill in the information for each new customer!



[Federal Truth in Lending Act]


Date: __________


FOR VALUE RECEIVED, the undersigned jointly and severally promise to pay to the order of _, the sum of _ [$_] Dollars in [_] consecutive, monthly payments of $_ each, beginning one month from date hereof and thereafter on the same date of each subsequent month until paid in full.  Any unpaid balance may be paid at any time without penalty and any unearned finance charges will be refunded based on the Rule of 78's.  In the event the undersigned defaults in any payment beyond _ days from the due date, the entire balance may be due at the option of the holder.


1. Proceeds                                   $_ 

2. Other charges [itemize]                    $_ 

3. Amount financed [1+2]                      $_ 

4. Total of payments                          $_ 

5. Annual Percentage Rate   _%





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