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JUDGMENT NO'rB
S 3,R2l.Rl
i\T. C<lr llll 1", CumlJt-lrland County, PA
FOR VALUE RECEIVEC, the underaigned jointly and aeverally promiae to pay to the ord~r
ot Nlltionwide Mutual Ineurance Company, '!hr.'", 'l'housand r:i< t llundrerl 1/e A
an.i 81/l0'1 ...._,__.___ Collan (S3,B2L.:n ) in monthly paymenta ",a ere na ter aet out.
It ia agued that the principal and intereet ot thia note ehall be paid in 30.51
conaecutive monthly inatallmente ot S 125.0') beginning Decerrber la. 1')'), ..nd
thereatter on the aarne date ot e..ch aubaequent month until th~e note h..a been paid in full
with intereat. Upon the failure to make anyone or more ot the a..id monthly inetallmenta the
entire amount remain~ng unp..id, principal and intereat, upon this note, ah..ll immadiat61y
become due and payable and entorceable ..t l..w at the option of the holder.
Upon failure to pay any inatallment ot principal or intereat, the entire unpllid
principal and intereat then remaining unpaid ahall immediately become due and payable at tile
option of the holder thereot, and I/we hereby authorize any Attorney at Law of any court ~f
record within the Unitad States and/or any prothonotary to appear for me/ua and cor.te~a
judqment againat me/ua in favor of the holder thereot, for the amount then appearing due "t
both principal and intereat, cost ot auit including an attorney's fee of 5 percent commiaai.>n
upon the balance due which shall include principal, interest and cost.
I/We ~o heraQ, \lAivv the i".\ling of any .ervico of proc8811, all riqht cr fiqhes ..,t
appeal and all bene tit or benet its from any and all errors in any and all p:oceedinqs h~u
hereupon for collection of the eaid debt, interest, cost and commission, and all righta und..r
any preaent or future Exemption Laws ot thia commonwealth.
I/We acknowledge receipt ot a copy ot this instrument I and acknowledge that this
obligation arouse out of an automobile
accident on or abOUt '\r>ril 26 , 19 137, tor which I/we were aole1y
reaponaible and did not carry l~ab~l~ty ~nsurance.
1. Amount Financed
3. Total ot Payment a
S 3, Cl21.:n
s 'l'l.ao ,
S 3,'321.81
$ I)!) .'11)
, .
2. FINANCE CHARGE
4. ANNUAL PERCENTAGE RATE
S. Thia note ia un.acured.
Signed, Sealed and Celivered in
the pr..ence ot
~~~
(S~)
~{ont3rt L. Dlehl
ADDRESS
1.7 ou' (J-~~ ;(,~R
C ....1./;.~ jP/I /7//11
IlOlIIIT "A.
17- ~~<('.. )S'cJ
Operator'a No.
~ ~ I k - ,{/
Date of Bire
1~ -tk~~' ~ +
~ On a(j.~''^7 j 01 /9 -; y
I '
, ,RIAl Su: l
\(l'u--.. \',,, 11 C';S~Ell, :IOllrv i'ullrC
,CdI:IIU, i:.;moerl~I:O CoiJr,IY 1
My L;,1n:ml!lslon txpir.s April 21. 19l17
Auto 20770.
VBRIPICATION
I, Stephanie A. Murphy, Esquire, affirm and state that
the annexed Installment Agreement with warrant of attorney is a
true and correct copy of the original Installment Agreement with a
warrant of attorney, upon which judgment is confessed herein and
that the allegations of fact contained in the foregoing statement
are true and correct.
This statement is made subject to
the penalties of 18 Pa. C,S.
Section 4904 relating to unsworn
falsification to authorities.
e
JAN 18
1002 an '95
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