Payment Plan Agreement

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Please complete the form in its entirety. Contact our offices for more information.
This serves to confirm that I am aware that the Faith Fellowship Car Dealership has a policy that requires each customer following the payment plan to
adhere strictly to the agreement laid forth below.

Please select one of the payment schedules listed below:


What is the amount to be

covered by the plan?  Weekly

$ .  Bi-Weekly
 Other ____________________________
(Please indicate)
By what date do you hope
Hence, I agree to pay $___________ every
to meet your financial
___________week(s) on the __________ day of each
obligations: (mm-dd-year) payment week. Payment should be sent to Perla’s Auto
Sales at 1418 W. 23rd St. Independence Mo, 64050 with
check or money order.

I, ________________________________, hereby consent to follow the payment agreement given above with
strict abidance. It is understood that if I make 3 late payments the car will be repossessed and I will lose all my
rights and money that I have given. I have read and understood the conditions of the agreement; should I have
any difficulty, I fully accept it as my responsibility to report this matter to the Office of Student Financing
before my next payment is to be made, so as to allow for alternate arrangements to be made.

Printed Name:

Signature: Date (dd/mm/year): ____ / _ / _____

Vehicle Info:

Return this form to our offices as soon as possible.

“Education is the golden key to open the door to success”


FOR OFFICIAL USE ONLY
Schedule: ______________________________ Verified by: ____________________
(Eg: $100 every 2 weeks on 3rd) (Name of Agent)
Notes
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Perla’s Auto Sales
1418 w. 23rd Street
Independence Mo, 64050
Tele: (816) 836-8211
Email: egrant103@aol.com Website: www.fcfti.org

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