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Manufacturer.
This is a legally binding contract. VENDOR INFORMATION
EQUIPMENT VENDOR NAME
If the terms and conditions are not fully understood,
legal advice should be sought before signing. ADDRESS
A. MONTHLY PAYMENT
1. I will pay ____ monthly payments of $ _________ each (the Lease Payment) to Lessor.
2. Each lease payment will have added to it an estimated sales or use tax of $ _______ and an estimated property tax
of $ ________.
3. Damage waiver is $ _________.*
4. The total monthly lease payment is $_________. (The sum of 1+2+3 above)
*See section 12 for an explanation of the damage waiver.
B. PAYABLE AT SIGNING C. TOTAL OF PAYMENTS/PAPER BILLING FEE
ADVANCE PAYMENT $ Total Monthly Lease Payment: $________________ Lease Term: _____
SALES OR USE TAX $ The amount I will have paid by the end of the Lease: $ _____________
(Total Monthly Lease Payment x Lease Term)
PROCESSING FEE $
Lease Payments and Due Dates: The Total Monthly Payment and applicable
DOWN PAYMENT $ taxes and fees are due by the same date of every month. The fee for
SECURITY DEPOSIT $ receiving Monthly Paper Bills if I do not authorize Automatic Payment is
TOTAL $ $5.00.
PRINT NAME
Lessee
You may CANCEL this transaction, without any Penalty or Obligation, within THREE (3) BUSINESS DAYS from
the above date.
If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable
instrument executed by you will be returned within TEN (10) BUSINESS DAYS following receipt by the seller of
your Cancellation Notice, and any security interest arising out of the transaction will be canceled.
If you cancel, you must make available to the seller at your residence, in substantially as good condition as when
received, any goods delivered to you under this contract or sale, or you may, if you wish, comply with the
instructions of the seller regarding the return shipment of the goods at the sellers expense and risk.
If you do make the goods available to the seller and the seller does not pick them up within twenty (20) days of
the date of your Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If
you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do
so, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail, fax or deliver a signed and dated copy of this Cancellation Notice, or any other
written notice or send a telegram, to TimePayment Corp. at 1600 District Avenue, Suite 200, Burlington, MA
01803 Attn: Cancellation Department.
ACKNOWLEDGEMENT OF RECEIPT
I have received two copies of this Buyers Right to Cancel and Notice of Cancellation
9/25/17
Lessee: _____________________________________
Signature Date
DATE: _________________________________________________
SIGNED: _______________________________________________
NOTICE OF CANCELLATION
ES 01/2016
1600 District Avenue, Suite #200, Burlington, MA 01803
You may CANCEL this transaction, without any Penalty or Obligation, within THREE (3) BUSINESS DAYS from
the above date.
If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable
instrument executed by you will be returned within TEN (10) BUSINESS DAYS following receipt by the seller of
your Cancellation Notice, and any security interest arising out of the transaction will be canceled.
If you cancel, you must make available to the seller at your residence, in substantially as good condition as when
received, any goods delivered to you under this contract or sale, or you may, if you wish, comply with the
instructions of the seller regarding the return shipment of the goods at the sellers expense and risk.
If you do make the goods available to the seller and the seller does not pick them up within twenty (20) days of
the date of your Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If
you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do
so, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail, fax or deliver a signed and dated copy of this Cancellation Notice, or any other
written notice or send a telegram, to TimePayment Corp. at 1600 District Avenue, Suite 200, Burlington, MA
01803 Attn: Cancellation Department.
ACKNOWLEDGEMENT OF RECEIPT
I have received two copies of this Buyers Right to Cancel and Notice of Cancellation
Lessee: _____________________________________
Signature Date
DATE: _________________________________________________
SIGNED: _______________________________________________
NOTICE OF CANCELLATION
ES 01/2016
1600 District Avenue, Suite #200, Burlington, MA 01803
You may CANCEL this transaction, without any Penalty or Obligation, within THREE (3) BUSINESS DAYS from
the above date.
If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable
instrument executed by you will be returned within TEN (10) BUSINESS DAYS following receipt by the seller of
your Cancellation Notice, and any security interest arising out of the transaction will be canceled.
If you cancel, you must make available to the seller at your residence, in substantially as good condition as when
received, any goods delivered to you under this contract or sale, or you may, if you wish, comply with the
instructions of the seller regarding the return shipment of the goods at the sellers expense and risk.
If you do make the goods available to the seller and the seller does not pick them up within twenty (20) days of
the date of your Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If
you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do
so, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail, fax or deliver a signed and dated copy of this Cancellation Notice, or any other
written notice or send a telegram, to TimePayment Corp. at 1600 District Avenue, Suite 200, Burlington, MA
01803 Attn: Cancellation Department.
ACKNOWLEDGEMENT OF RECEIPT
I have received two copies of this Buyers Right to Cancel and Notice of Cancellation
Lessee: _____________________________________
Signature Date
DATE: _________________________________________________
SIGNED: _______________________________________________
NOTICE OF CANCELLATION
ES 01/2016
1600 District Avenue, Suite #200, Burlington, MA 01803
AMENDMENT
MULTIPLE EQUIPMENT AGREEMENT
This amendment makes reference to the attached Lease Agreement bearing the above referenced Authorization
Number. The attached Lease Agreement is incorporated herein by reference. This amendment supersedes only
the Equipment Description Information Sections contained in the Lease Agreement.
TIMEPAYMENT CORP
SIGNATURE DATE