format of Disclosure Statement On Small Business/Retail/Consumer Credit
format of Disclosure Statement On Small Business/Retail/Consumer Credit
____________________________________
(Business Name of Creditor)
4. SCHEDULE OF PAYMENTS
Explanation: The effective interest rate is higher than the contractual interest
rate of % because of Item 2 deductions above.
6. CONDITIONAL CHARGES THAT MAY BE IMPOSED (if applicable). Please specify manner of imposition:
CERTIFIED CORRECT:
________________________________________ ________________________________________
(Signature of Creditor/Authorized Position
Representative Over Printed Name)
________________________________________ ________________________________________
(Signature of Borrower over Date
Printed Name)
__________________________________________________________________________
AMORTIZATION SCHEDULE
(Sample Only)
Installment (A) Loan (B) Principal (C) Interest (D) Total (E) O/SBalance
(F)
xxx xxx
Legends:
Footnotes
1. Notes
Itemize all charges including advance deductions
– Small business/Retail/Consumer Loans includes microfinance, auto (motor), salary, personal, medical,
educational and other loans of similar nature
– This document contains the minimum information required to be disclosed to the borrower and may be
enhanced to improve client information