Customer Disclosure Form

    CUSTOMER AGREEMENT AND DISCLOSURE STATEMENT FOR
    INSTALLATION OF STARTER INTERRUPT/GPS DEVICE. IMPORTANT: READ THIS ENTIRE DOCUMENT. IT DESCRIBES THE CONSEQUENCES OF FAILING TO MAKE TIMELY PAYMENTS. YOU SHOULD
    CONSULT THE CREDITOR BEFORE SIGNING THIS DOCUMENT IF YOU DO NOT UNDERSTAND ANY OF THE TERMS OF THIS AGREEMENT AND DISCLOSURE. * Required fields

    Date*

    Creditor Name*

    Creditor Address*

    Customer(s)*

    Vehicle Description*

    Customer(s) (“you” and “your”) and Creditor (“we”, “us”, and “our”) enter into this Agreement
    and Disclosure made pursuant to the motor vehicle retail installment contract (“Contract”)
    executed by you and us for the purchase and financing of the vehicle (“the Vehicle”) identified
    and described above. This Agreement and Disclosure, when submitted by you, is
    incorporated into and becomes part of the Contract. By checking the box next to I UNDERSTAND on each area below and submitting this form, you acknowledge your understanding of and agreement to each of the terms of this Agreement and Disclosure.

    Description of the Device

    The Vehicle has been equipped with a starter interrupt device with GPS
    capabilities (“the Device”) designed to protect our interests in the Vehicle in the
    event you fail to keep your promise to make payments when due under the
    Contract. Subject to any grace or cure periods and any notice required by
    applicable law, and as described more fully below, the Device allows us to
    prevent the Vehicle from restarting if we do not receive a payment as scheduled. *

    I accept.I do not accept.

    The Device’s GPS capabilities allow us to obtain the location of the Vehicle to
    assist in repossession in the event we must take back the Vehicle due to your
    default. The GPS capabilities also enable us to protect our security interest in the
    Vehicle through periodic checks of the Vehicle’s location. These checks ensure
    that the Vehicle has not been permanently moved to another location without our
    knowledge. The Device can also help to recover the Vehicle in the event that it is
    stolen. *

    I accept.I do not accept.

    You will not be charged for the Device or for its installation. We own the Device.
    We will remove the Device from the Vehicle upon your written request when you
    have satisfied all of the obligations under the Contract. To have the device
    C#4837-1296-2306 2
    removed after you satisfy all the obligations under the Contract, write to us at the
    address identified above. *

    I accept.I do not accept.

    As the owner of the Device, only we or our authorized representatives are
    permitted to repair and perform maintenance on the Device or any of its
    components. You agree to make the Vehicle available to us or our authorized
    representative should maintenance or repair work become necessary. You will
    not be responsible for the costs of any repairs or replacements of the Device,
    except if repair or replacement is caused by your tampering with, altering,
    disconnecting or removing the Device. To the extent not prohibited by applicable
    law, you will pay the costs of necessary repairs or replacements required because
    you tampered with, altered, disconnected, or removed the Device.
    *

    I accept.I do not accept.

    If You Default

    You are obligated to make timely payments to us under the Contract. If we do not
    receive a payment from you on or before the scheduled due date, you will be in
    default. You also will be in default under the Contract if you tamper with, alter,
    disconnect or remove the Device, to the extent not prohibited by applicable law.
    *

    I accept.I do not accept.

    If you default on your obligations to us, the Device enables us to disable the
    Vehicle’s starter from a remote location and to track the Vehicle’s location using
    satellite technology. We may use the Device’s GPS capabilities to locate the
    Vehicle or for any other purpose not prohibited by applicable law.
    *

    I accept.I do not accept.

    If we disable the starter, and subject to any grace or cure periods and any notice
    required under applicable law, you will not be able to restart the Vehicle until you
    have paid us the amount necessary to bring your payments current under the terms
    of the Contract or have otherwise cured your default.
    *

    I accept.I do not accept.

    If you fail to cure the default, we may take any action as permitted under
    applicable law, including THE RIGHT TO REPOSSESS THE VEHICLE. We
    will use the Device’s GPS technology to locate the Vehicle for this purpose and
    any other purpose not prohibited by applicable law.
    *

    I accept.I do not accept.

    If we use the Device to disable the starter due to your default and you experience
    an emergency requiring you to have access to an operational vehicle, you may
    request and we may provide you with the ability to restart your Vehicle. We are
    not obligated to provide you with emergency access, however. Such emergency
    access will be given at our discretion. To request emergency access, call us at
    the number listed on the website. There may be some times of the day when you
    are less likely to reach us to make a request for emergency access, particularly if
    you call other than during our normal business hours.
    *

    I accept.I do not accept.

    If we grant emergency access, in most cases we will be able to override the
    disablement of the starter from a remote location. However, you may be required
    to manually override the starter. The manual override will require you to turn the
    key from the off position to on and back to the full off position for a given
    number of times and in a certain sequence. We will instruct you how to do this in
    the event a manual override is required.
    *

    I accept.I do not accept.

    If we grant emergency access, the Vehicle will remain operational for 24 hours
    after access is granted, after which the starter will again be disabled if you have
    not cured your default. Our granting of emergency access shall not be deemed a
    waiver of our rights under the Contract.
    *

    I accept.I do not accept.

    We have the right to assign our rights, title and interest in the Contract at any
    time. If the Contract is assigned, the holder of the Contract will have all of our
    rights under the Contract, including those incorporated into the Contract by this
    Agreement and Disclosure.
    *

    I accept.I do not accept.

    We require the installation of the Device in the Vehicle as a condition to our
    extension of credit to you under the Contract. You are not obligated to purchase a
    vehicle from us. You are free to obtain a vehicle or vehicle financing from
    another source that does not require installation of the Device or a similar starter
    interrupt system. By executing this Agreement and Disclosure and the Contract,
    you acknowledge that you have voluntarily chosen to purchase and finance the
    Vehicle and consent to having the Device installed in the Vehicle.
    *

    I accept.I do not accept.

    BY SIGNING BELOW, you agree to the Device’s installation and to its use until you
    satisfy all of the obligations under the Contract. In addition, you acknowledge that you
    understand how the Device works and agree that the installation and maintenance of the
    Device in the Vehicle is a material condition for us to finance your purchase of the Vehicle,
    and as such constitutes consideration for the terms of the Contract. You acknowledge that
    you have read, understand, and agree to the terms of this Agreement and Disclosure
    regarding your right to override the disablement of the starter in the event of an
    emergency. You acknowledge that you have had any questions regarding the Device
    answered to your satisfaction.

    BY SIGNING BELOW, you voluntarily waive any right you may have to privacy in the
    location of the Vehicle and authorize us to use the GPS capabilities to locate the Vehicle if
    you default or for any other purposes not prohibited under applicable law. You also agree
    to hold harmless, defend and indemnify us, our agents, employees, and servants, and each
    of them, from all claims, demands, causes of action, damages, costs, liabilities or losses, in
    law or equity, to property or person suffered or sustained by any other person or entity
    arising out of or resulting from the intended use or termination of the Device in the
    Vehicle, to the fullest extent permitted by applicable law.

    BY SIGNING BELOW, you acknowledge that you have been warned not to sign this
    document before you read it. You understand that you are entitled to receive a copy of this
    document. By signing below, you acknowledge reading and receiving a copy of this
    document and agreeing to its terms.