INSURANCE PREMIUM FINANCE AGREEMENTInsurance Premium Finance Agreement • August 3rd, 2009
INSURED AGENT : Drivers License : a. TOTAL PREMIUM(CASH PRICE)b. LESS DOWN PAYMENT(+F&T)c. AMOUNT FINANCEDd. FINANCE CHARGE **e. TOTAL OF PAYMENTS (c+d) NUMBER OF MONTHLY PAYMENTSf. AMOUNT OF EACH PAYMENTg. TOTAL SALE PRICE (a+d+taxes+fees) Tax amountFee amount h. ANNUAL PERCENTAGE RATEFIRST PAYMENT DUE Policy # Effective Date Term Code Name of Insurance Carrier and MGA Total Premium Policy Type :
COMMERCIAL INSURANCE PREMIUM FINANCE AGREEMENT AND DISCLOSURE STATEMENTInsurance Premium Finance Agreement • November 22nd, 2023 • California
Borrower (Insured): Name and Address as stated in Policy Agency Test Loan MW TEST AGENCY 123 Main St 1234 Main St Detroit, MI- 94931 San Diego, CA- 92101 [123] 456-7890 Taxpayer ID #: Agency ID:
