NOTICE TO CUSTOMER REQUIRED BY FEDERAL LAW
Today, 06 April, 2005, you have entered into a transaction which Federal Law gives you the right to cancel, if you so desire, without any penalty or obligation at any time within three business days from the above date. By canceling this transaction, any lien, mortgage or other security interest resulting from this transaction is automatically void. Any down payment or other consideration you may have tendered on entering this transaction must be refunded to you in the event you cancel. If you desire to cancel this transaction, you may do so by notifying the following party:
<First name Last name
Street Address 1
Street Address 2
City, ST ZIP>
by mail or telegram sent by midnight <three days from now>, or by any other form of written notice delivered to the above address no later than midnight <three days from now>.
Please acknowledge your receipt of this notice by signing the form indicated below.
ACKNOWLEDGMENT OF RECEIPT OF NOTICE
Each of the undersigned hereby acknowledges the receipt of two completed copies of this Notice of Right of Rescission.
___________________________________ Date: _____________
___________________________________ Date: _____________