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'r"h~ ~lfl®~ ~A psM Indiana OG06031ND: 13432
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<br />LAST NAME BLACKTHORN GOLF CLUB FIRST NAME MIDDLE INITIAL
<br />STREET ADDRESS 6100 N I117Z PK~lY APT #
<br />CITY SOUTH BEND STATE IN ZIP CODE 46679-6 1 1 1 _
<br />HOME PHONE # (574122-41 S~ BUS. PHONE # S7
<br />(~4 X232-4653
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<br />MAKE MODEL
<br />YEAR ~,
<br />VIN # ~~.BI(,~$~,~3,6~r MILEAGE
<br />CHARGE TO YOU FOR THE ONE GAP ADDENDUM: $ ~~ ORIGINAL DATE OF CONTRACT
<br />FINANCING CONTRACT/LOAN ^ AMOUNT FINANCED $ eoe~ e~_ TERM (Mos.) ~_ NEW ~ USED BALLOON ^
<br />MSRPMADA $ 30479.00 Max Limit of MSRP/NADA 150°/L~fOf 120%^ Max Term of GAP 84 MONTHS Fa Administrative Purpose: CLA33
<br />DEALER # DEALERSHIP _ JORDAN AUTOMOTIVE
<br />STREET ADDRESS 609 E JEFFERSON BLVD
<br />CITY MTCUeUeYe STATE *~
<br />a~uauw aw~w~wn~aa ~ ZIP CODE _ +`.r
<br />FINANCIAL INSTITUTION ACCT. #
<br />STREET ADDRESS ~~~8 ~1/7f~rE'NV~z6E RB-ATE-3~A
<br />CITY ~W~~RS GROVE STATE ~~ ZIP CODE 6v5~5
<br />This Guaranteed Automobile Protection (GAP} Contract Addendum (addendum) amends the Financing Contract. This GAP addendum is between the
<br />Customer/Borowernnd the Dealer/Creditor (we, us or our), or if assigned with the Financial lnstltution/L.ender.
<br />Although not required to do so, you have elected to participate in our GAP Program You may be able [o obtain GAP coverage from your primary insurance
<br />carrier. GAP does not take the place o[ insnrance on the Covered Vehicle. You are responsible for maintaining wllision.and comprehensive insurance for
<br />the full value of the Covered Vehicle and any other insurance required by the Financing Contract or applicable law. You are responsible for all notifications
<br />or claims that are required to be filed wiUl your automobile insurance company. We will not process or handle your insurance claims for you.
<br />In the event of a Constructive Total Loss to the Covered Vehicle, we agree to waive our rights against you for the amount due under a Payable Loss. In
<br />addition to the provisions of Payable Loss, you will remain responsible for payment of any items stated under Exclusions.
<br />TERMINATION OF ADDENDUM: This addendum will terminate on the date that either of the following events occur: 1. the date your Financing Contract
<br />is scheduled to terminate; 2. upon payment im full of the Financing Contract; 3. expiration of amy redemption period following the repossession or surrender of
<br />the Covered Vehicle; 4. in the event of a Constructive Total Loss or theft of the Covered Vehicle; or 5. the date the Financing Contract is prepaid or the
<br />Financing Contract is refinanced. If you wish [o cancel and terminate this coverage prior to prepayment in full of the Financing Contract, it is your
<br />responsibility to notify the Dealer/Creditor, in writing, of your request to cancel this coverage and to request arefund/credit of the GAP charges.
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<br />YOUR RIGHT TO CANCEL: You have the unconditional right to cancel and terminate this optional addendum for a refund/credit of the unearned
<br />portion of the charge for this addendum at any time. H any termination occurs within 30 days o[ the addendum purchase you wiB receive a toll
<br />refund/credit of the addendum cost, provided no loss has occurred. Otherwise, you wilt receive arefund/credit of the addendum cmt calculated by
<br />the Pro Rata method. V/e will refund all charges to the Dealer/Finandal Institution/I.ender for credit to your account. To cancel the addendum and
<br />request arefund/credit, you must rnntact the Dealer/Creditor, in writing, at the address shown above. If you do not receive the refund/credit within
<br />60 days of notice of cantxUatiodtermination, contact the GAP Administrator stated above.
<br />ENROLLMENT IS AVAII,ABLE ONLY AT THE TIME THE FINANCING CONTRACT IS ORIGINALLY EXECUTED. BY YOUR SIGNATURE
<br />BELOW, YOU ACKNOWLEDGE AND AGREE THAT YOUR ACCEPTANCE OF THIS GAP ADDENDUM is VOLUNTARY AND IS NOT
<br />REQUHtED IN ORDER FOR YOU TO OBTAIN CREDIT, DOES NOT II14PACI' YOUR ABILITY TO OBTAIN ANY PARTICULAR OR MORE
<br />FAVORABLE CREDIT TERMS, AND HAS NO EFFECT ON THE TERMS OF THE RELATED SALE OF THIS VEHICLE. This coverage may
<br />decrease over the term of your Financing Contrail and may not extend for the full term of your Financing Contrail. H the original unpaid net
<br />balance exceeds the MSRP/NADA value multiplied by the maximum percentage shown above, the benefit may not rnver the entire amount due at the
<br />time of loss. You also acknowledge that you have read and understand this addendum and its provisions. No other verbal representations have been made to
<br />you that differ from these wriUen provisions. If you purchase GAP from this Dealer/Creditor, you understand that the Dealer/Finamcial Institudon/l,ender may
<br />retain all or a portion of the charge paid by you. You should carefully read the back of this addendum for additional information on eligibility, requirements,
<br />conditions and exclusions that could prevent you from receiving benefits under this addendum.
<br />ASSIGNMENT: The GAP addendum will follow the Financing Contract with no subrogati ri against the Customer/Borrower, if the Financing
<br />Contrail is sold or assigned by the Dealer/Creditor. y/
<br />Cus[omer/Botrower Dealer/Ctedi
<br />QI ert!TiJl1QY G(11 [ f•1 I IB nr r r e Tnp to
<br />LIiI~IITATIONS:
<br />A. No addendum wiB be valid for the Covered Vehicle with a Manufacturer's Suggested Retail Price (MSRP) or NADA retail value of more than 5100,000,
<br />or if the amount financed exceeds S 100,000, or if the amount financed, less the cost of GAP, Credit Insurance and/or warranties, is less than 80% of the
<br />MSRP/NADA retail value.
<br />B. No coverage is provided for that portion of the Net Payoff that results from the amount financed cost exceeding the Maximum Eligibility Limit stated
<br />above at the inception date of this addendum and will be deducted from the Payable Loss due.
<br />C. The Payable Loss for Financing Contract with terms greater than the Maximum Term of GAP stated above will be based on a Net Payoff calculated using
<br />the Maximum Term of GAP stated above.
<br />D. Any addendum issued for an amount financed in excess of B or C above will be deemed eligible for enrollment as limited by this section.
<br />E. No coverage is provided for a Financing Contract that does not have uniform monthly repayment retms for the full period of the financing agreement
<br />(except for balloon Financing Contract with uniform payments) and/or for a Financing Contract that is Self-Finattced.
<br />The One GAP ADMINISTRATOR, 483 South Kirkwood Road, PMB# 71. Kirkwood, MO 63122 /Phone (800) 856-2320 Fax (636) 680.0048
<br />For atlditioaal uatoruwtlou or complatnls, contact:
<br />Indiana Department of Financial Institutions, 30 S. Meridian St, Ste 300, Imdwaapolis, IN 4620.1, 500-382.48811
<br />White • CUSTOMER BORROWER Yeiloiv • ADMINISTRATOR Piny • DEALER/ CREDITOR Goldenrod • ASSIGNEE
<br />OG0603IND -WHITE OG0603IND-FP530 (Ol-07)
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