Installment Note	
	
$			, 20___      	
	
          FOR VALUE RECEIVED, the undersigned promise(s) to pay to 		
	the principal sum of 	
	DOLLARS ($ 	)	
and interest from 	 on the balance of principal remaining from time to 	
time unpaid at the rate of 	 per cent per annum, such principal sum and	
interest to be payable in installments as follows: 		
	DOLLARS ($ 	) on the	day of 	, 20 	,	
and 	DOLLARS ($ 	)	
on the 	day of each and every month thereafter until this Note is fully paid, except that the 	
final payment of principal and interest, if not sooner paid, shall be due on the 	 day of	
	, 20	.  All such payments on account of the indebtedness evidenced by this	
Note shall be applied first to accrued and unpaid interest on the unpaid principal balance and the	
remainder to principal.	
          Payments are to be made at 		
	, or at such other place as the legal holder of this Note may from time	
to time in writing appoint.	
          And to secure the payment of said amount, the undersigned hereby authorizes, irrevocably, 		
any attorney of any Court of Record to appear for the undersigned in such Court, in term time or	
vacation, at any time after maturity, and confess a judgment, without process, in favor of the holder	
of this Note, for such amount as may appear to be unpaid thereon, together with reasonable costs 	
of collection, including reasonable attorney’s fees and to waive and release all errors which may 	
intervene in any such proceedings, and consent to immediate execution upon such judgment,	
hereby ratifying and confirming all that said attorney may do by virtue hereof.	
          At the option of the legal holder hereof and without notice, the principal sum remaining 	
unpaid hereon, together with accrued interest thereon, shall become at once due and payable at 	
the place of payment aforesaid in case default shall occur in the payment, when due, of any	
installment of principal or interest in accordance with the terms hereof.	
          All parties hereto severally waive presentment for payment, notice of dishonor, protest and	
notice of protest.	
	
	(signed)	

INSTALLMENT NOTE		Received on the within Note
the following sums	
			Date	Interest	Principal	Remarks	
			20		Dollars	Cts.	Dollars	Cts.		
TO									

									
Date  	 20 										
Amount 	 $										
Monthly  	 $										
Last payment due									
  	, 20 										

									

									

									

									

									

									

									

									

									

		Date	Interest	Principal	Remarks	
		20		Dollars	Cts.	Dollars	Cts.