This statement sets out, in one place, what the Vehicle costs, what the Buyer is paying for deferred payment, and what the Buyer will owe in total. The Buyer should read it before signing anything.
1. Transaction
#| Seller | blank |
| Buyer | blank |
| Vehicle (year / make / model / VIN) | blank |
| Date of disclosure | blank |
2. Price
#| Line | Description | Amount |
| A | Cash price — what the Vehicle would cost if paid in full today | $blank |
| B | Seller’s disclosed markup for deferred payment | $blank |
| C | TOTAL SALE PRICE (A + B) | $blank |
| D | Down payment paid at signing | $blank |
| E | AMOUNT FINANCED BY THE SELLER (C − D) | $blank |
The markup at line B is the Seller’s entire profit for allowing payment over time. It is fixed today. It does not grow, does not compound, and does not increase if a payment is late. There is no interest rate applied to any balance.
3. Payments
#| Number of payments | blank |
| Amount of each payment | $blank |
| Amount of final payment | $blank |
| Payment frequency | Monthly |
| First payment due | blank, 20blank |
| Final payment due | blank, 20blank |
| Total of payments | $blank |
| Total the Buyer will have paid (down payment + all payments) | $blank |
4. Rate-equivalent information
#The Buyer is not being charged interest. However, because payment is deferred and the total price exceeds the cash price, United States consumer credit rules may treat the difference as a finance charge and may require an equivalent annual percentage rate to be shown. That figure is provided below purely so the Buyer can compare this transaction with conventional offers. It is a mathematical comparison, not a rate being charged.
| Cash price (line A) | $blank |
| Amount treated as a finance charge (line B) | $blank |
| Equivalent annual percentage rate, for comparison only | blank % |
5. Security
#The Buyer is giving the Seller a security interest in the Vehicle being purchased. The Buyer will be the registered owner. The Seller will be recorded as legal owner / lienholder with the California DMV until the Total Sale Price is paid in full.
If the Buyer does not pay as agreed, and does not cure after receiving written notice, the Seller may take back the Vehicle and sell it. Any surplus after costs and the balance owing is returned to the Buyer. If the sale does not cover the balance, the Buyer may still owe the difference, reduced by the unearned portion of the markup.
6. Other terms
#| Late charge | $blank per late payment, capped at $blank per month, payable to charity and not retained by the Seller |
| Grace period | blank days from the due date |
| Early payoff | Permitted at any time with no penalty. Any reduction of the markup is at the Seller’s discretion and is not promised |
| Insurance | Comprehensive and collision required throughout, with the Seller named as lienholder and loss payee |
| Vehicle condition | Sold as-is by a private seller, subject to the disclosures in document 07 |
7. Buyer acknowledgment
#The Buyer acknowledges receiving and reading this statement before signing the sale agreement, and that the figures above match the sale agreement.
Buyer signature: blank Date: blank
Print name: blank
Seller signature: blank Date: blank
Print name: blank