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Pawn Transaction Disclosure and Agreement




Consumer’s Name:                                                                                                                                                                                                                                               Date:                                   




Other ID (e.g., Date of Birth; Driver’s License Number):                                                                                                                                                                                                                               

Description of Property:                                                                                                                                                                                                                                                                                     





The amount of credit extended to you or on your behalf.





The dollar amount the credit will cost you.






The amount you will have paid after you have made all payments as scheduled.





The cost of your credit as a yearly rate.




PAYMENT SCHEDULE: 1 @ $                                                                                       DUE DATE:                                                           


PREPAYMENT: If you pay off early, you (_____ will) (_____ will not) be entitled to a refund of part of the finance charge.


SECURITY: You are granting a security interest in the property described above.


See your agreement (contract) documents for any additional information about nonpayment, default, any repayment in full before the scheduled date, and prepayment refunds and penalties.

Itemization of Amount Financed of $                                                               ;                               Amount Give to you Directly    $                                                                        

                                                                                                                                                                Amount Paid on your Account $                                                                        

Periodic (monthly) rate:                                                       %


Maine law authorizes a minimum finance charge of $2.50.




Consumer pledges the property listed above as collateral for this pawn transaction.  Consumer is not obligated to redeem the collateral.  To redeem the collateral, consumer agrees to pay the “Total of Payments” on or before the “Due date” (above), or the extension date, if one is agreed to.  Pledged goods not redeemed on or before the Due date or extension date become the property of the pawnshop.  Consumer warrants that he or she has clear title to the item(s) pledged as collateral.


REDEMPTION: You may redeem the item(s) by paying the “TOTAL OF PAYMENTS” (above) on or before the “DUE DATE” (above).


Consumer’s Signature:                                                                                                      Pawnbroker’s Signature:                                                                    


Extension date, if any:                                                                                         


Consumer’s Signature on Redemption:                                                                                                         Date:                                                                       


NOTICE: You are entitled by law to at least one extension of one month at the same rate of interest upon request in writing or in person.


FORM REV: 09-16-97