Congratulations: Corey Brown - Rodeo Media Relations

Corey Brown
1482 Poetry Rd
Royse City, TX 75189
Application ID:
Approval Date:
Expiration Date:
257806
9/26/2012
10/26/2012
Monthly Savings: $13.31
For your files
Congratulations:
Corey Brown
COVER LETTER
You have been approved to refinance your vehicle. You might even be able to skip your next
payment. Just follow the steps below and you will be saving money….…FAST!
Keys to Saving Money
Start today! We can save you money so just follow the steps and reference symbols below.
DO NOT CROSS OUT ITEMS OR MAKE CHANGES. PLEASE SIGN ALL DOCUMENTS
EXACTLY AS YOUR DRIVER’S LICENSE. THESE DOCUMENTS ARE TIME SENSITIVE!
If you have any questions or want to make changes, please call us at (888) 536-3024.
STEP 1: Complete and gather the following documents
Copy of current Vehicle Registration (Proof of Ownership)
(If registration expires within the next 30 days, renewal is required)
Copy of current Driver’s License for buyer/co-buyer
(Please contact us if documents don’t match name as printed on driver’s license)
Copy of current Insurance Card
Proof of income (if applicable)
Proof of residence – Copy of utility bill or bank/cred card statement within last 30 days
Completed Customer Information sheet (included in this package)
Authorization for Payoff – Borrower(s) must sign and date
Power of Attorney – Borrower(s) must sign and date
(Original document must be mailed to OpenRoad Lending)
Note and Security Agreement – Borrower(s) must sign
Kinecta Membership Application (2 pages)
(Complete highlighted information on page 1 and sign both pages)
GAP Form and/or Warranty form (only return the signature page)
STEP 2: Please scan and email to loanhelp@openroadlending.com or fax your documents to
(866) 228-8446 EXCEPT the original Power of Attorney which must be mailed to:
OpenRoad Lending
Attn: Refinance Dept.
6616 Davis Boulevard
North Richland Hills, TX 76182
STEP 3: Return any original documents within 7 days to avoid delays in processing your loan
Phone: (888) 536-3024
Fax: (866) 228-8446
Email: loanhelp@openroadlending.com
Hours: Monday through Friday 8am – 5pm CST
CONTACT US
REFERENCE SYMBOLS
File this document Sign this document Email/Fax this document back
Complete this document
Return the original via mail or overnight service
ORLKINTX-CL-v2.2 09132012

TO: OpenRoad Lending FROM: Corey Lynn Brown
FAX: (866) 228-8446 Application ID:
ATTN: Funding Department # of Pages: (including cover)
Expiration Date:
257806
10/26/2012
CUSTOMER INFORMATION SHEET
Don’t forget to include a copy of a valid Driver’s License for each borrower, a copy of your current
insurance card and vehicle registration.
My References: No references in the same household.
Complete
Sign
Email/Fax back
1) Name: 2) Name:
Address:
Address:
City:
City:
State: Zip: State: Zip:
Phone #: Phone #:
Relation:
Relation:
My Driver Information:
Borrower
Driver’s License #:
Driver’s License
Expire Date:
License Plate #:
Vehicle Color:
Co-Borrower
My Current Automobile Insurance Information:
Insurance Company: Agent’s Phone #:
Agent’s Name: (if applicable)
Policy Number:
My Employment Information:
Employer Name: R & R MILLWORK
HR/Payroll or Manager Phone #:
HR/Payroll or Manager:
Borrower Signature:
You are giving OpenRoad Lending authorization to verify your employment as stated on the application.
SIGN HERE
Co-Borrower Employment Information:
Employer Name: HR/Payroll or Manager Phone #:
HR/Payroll or Manager:
Co-Borrower Signature:
You are giving OpenRoad Lending authorization to verify your employment as stated on the application.
CO-SIGN HERE
ORLST-FCL-v2.0 04012012

Application ID:
Approval Date:
Expiration Date:
257806
9/26/2012
10/26/2012
Sign
Email/Fax back
Current Lienholder:
Lienholder Phone:
Borrower:
Co-Borrower:
Loan Account #:
Payoff Amount:
Good Through:
Vehicle:
VIN #:
New Lender:
AUTHORIZATION FOR PAYOFF
Wells Fargo Dealer Services
800-289-8004
Corey Lynn Brown
5780190774
$15,248.48
10/12
2008 MAZDA CX-7-4 CYL TURBO
JM3ER293680214658
OpenRoad Lending, LLC
I hereby authorize Wells Fargo Dealer Services to accept enclosed funds from OpenRoad Lending to pay off
the balance due on the Loan Account number and Vehicle described above. I authorize Wells Fargo Dealer Services
to release information on the above noted Loan Account to OpenRoad Lending, including but not limited to the terms
of the account, the payoff amount, the daily per diem, the number of payments, and the last payment applied. I
authorize OpenRoad Lending to add up to 10% to the Payoff Amount if the above amount does not pay off the existing
lien. Upon receipt of the above amount, Wells Fargo Dealer Services
is instructed to surrender the title to the
above described Vehicle as indicated below. If this transaction relates to a branded, salvaged or reconditioned title, or
title listing additional lienholders, or a shortage in the amount of the payoff, please contact OpenRoad Lending
immediately at (888) 536-3024.
In the event that Wells Fargo Dealer Services
mistakenly remits the title to the Borrower and/or Co-
Borrower, the undersigned Borrower and/or Co-Borrower will notify OpenRoad Lending immediately at (888) 536-3024
Option 3. The Borrower and/or Co-Borrower will forward the title to OpenRoad Lending at the following address:
OpenRoad Lending, Attention: Refinance Department, 6616 Davis Boulevard, North Richland Hills, TX 76182
Corey Lynn Brown
Date
Date
SEND PROPERLY ENDORSED TITLE TO:
OpenRoad Lending
6616 Davis Boulevard
North Richland Hills, TX 76182
Phone (888) 536-3024
SIGN HERE
CO-SIGN HERE
Phone: (888) 536-3024
Fax: (866) 228-8446
Email: loanhelp@openroadlending.com
Hours: Monday through Friday 8am – 5pm CST
CONTACT US
ORL-AFP-v2.0 12052011

Application ID: 257806
Approval Date: 9/26/2012
Expiration Date: 10/26/2012
Sign
Return the original
POWER OF ATTORNEY TO TRANSFER MOTOR VEHICLE
POWER OF ATTORNEY
This is to certify that I,
Corey Lynn Brown
, of the County of _______________ and the State of
TX , owner of the following described motor vehicle, do make, constitute and appoint Pam Box of
OpenRoad Lending, LLC, 6616 Davis Boulevard, North Richland Hills, TX 76182, my true and lawful attorney, for me
and in my name, place and stead to perfect the lien, sell, transfer and assign the motor vehicle described as follows:
Year Make Model
2008 MAZDA CX-7-4 CYL TURBO
Body Style
WAGON 4D SPORT AWD
VIN
JM3ER293680214658
Giving and granting unto my said attorney full power and authority to do and perform all and every act requisite and
necessary to transfer and assign the legal title to said motor vehicle to anyone whomsoever as may be designated by
my said attorney, and to make, execute, acknowledge, verify, swear to, deliver, endorse, negotiate, record and file, in
my name, place and stead, all agreements, instruments, documents, assignments and certificates, including a title lien
statement, that my said attorney in its sole discretion deems advisable, desirable, proper and/or necessary for my said
attorney to grant, receive, maintain or perfect a security interest in said vehicle.
Federal Law (and State Law, if applicable) requires that you state the mileage upon transfer of ownership. Failure to
complete or providing false statement may result in fines and/or imprisonment.
I further certify that the current odometer reading is 64047 miles and to the best of my knowledge the
odometer is the ACTUAL mileage of the vehicle unless one of the following statements is checked:
1. The mileage listed above reflects my actual mileage.
2. The mileage stated is in EXCESS of the mechanical limits.
3. The odometer reading is NOT the actual mileage.
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT
THE FACTS STATED IN IT ARE TRUE.
Corey Lynn Brown
Name of Owner
Signature of Owner
1482 Poetry Rd Royse City, TX 75189
Borrower Address
City, State Zip
SIGN HERE
Date
* Any alteration or erasure voids this Power of Attorney
Phone: (888) 536-3024
Fax: (866) 228-8446
Email: loanhelp@openroadlending.com
Hours: Monday through Friday 8am – 5pm CST
CONTACT US
ORL-POA-v2.0 12232011

NOTE AND SECURITY AGREEMENT
Sign Email/Fax back
Date of Note: 9/28/2012 Application ID: 257806
BORROWER:
CO-BORROWER:
ADDRESS:
Corey Lynn Brown
1482 Poetry Rd
Royse City, TX 75189
LENDER:
OpenRoad Lending, LLC
6616 Davis Boulevard
North Richland Hills, TX 76182
I promise to pay the Amount Financed plus the accrued interest to the order of you, the Lender or your successors and assigns. I will make the
payments at your address above or at any other address you may provide me. I will make the payments on the dates and in the amounts shown in the
Payment Schedule. If the first payment date falls on the 29 th , 30 th or 31 st day of the month, I will make the payment in any month without such a date
on the last day of such month. Each payment I make will be applied to the amounts owing under this Note in any order you choose that is permitted
by applicable law. In this Note and Security Agreement (“Note”), Borrower is referred to as “I” or “me.” The Lender is referred to as “you” or
“your.”
TRUTH IN LENDING ACT DISCLOSURES
ANNUAL PERCENTAGE RATE FINANCE CHARGE Amount Financed Total of Payments
The cost of my credit as a yearly rate.
8.49%
The dollar amount the credit will
cost me.
$3,162.71 e
The amount of credit provided
to me or on my behalf.
$15,895.48 e
The amount I will have paid
after I have made all payments
as scheduled.
$19,058.19 e
My Payment Schedule Will Be:
Number of Payments Amount of payments When Payments Are Due
51 $373.69 e
Monthly, beginning 30 days from the date of funding until paid in full.
Security: I am giving you a security interest in the motor vehicle described as follows:
2008 MAZDA CX-7-4 CYL TURBO VIN: JM3ER293680214658 and all collateral as defined in this Note.
Prepayment: If I pay off early, I will not have to pay a penalty.
Filing Fee: I agree to pay any lien filing fees.
Insurance: Property insurance is required. I may obtain property insurance from anyone that is acceptable to you.
Late Charge: If payment is not received in full within 10 days after it is due, I will pay you a late charge of 5% of the full amount of the
payment.
Other Terms: See the terms and conditions of this Note for any additional information about nonpayment, default, any required repayment in
full before the scheduled due date, and prepayment refunds and penalties.
e means an estimate
The estimates that appear above are based upon information provided by my previous lender. See page 2 for additional information if the actual
amounts differ from the estimated amounts. The final terms of my repayment obligation will be provided to me in a separate Disclosure Pursuant to
the Truth in Lending Act, which is incorporated herein by reference.
POWER OF ATTORNEY. I appoint
you, through your appointed officer or
employee, as my attorney-in-fact. As my
attorney-in-fact, you can sign on my behalf
all Certificates of Title, Registration Cards
or other documents required to register and
maintain a properly perfected security
interest in the vehicle in your favor until all
obligations I owe under this Note are paid
in full.
ITEMIZATION OF AMOUNT FINANCED
I authorize you to pay the following amounts on my behalf:
1. Amount given directly to me $ 0.00 (1)
2. Amount paid on my account $ 0.00 (2)
3. Other charges including amounts paid to others on my behalf
(Lender may retain a portion of these amounts)
A. To Wells Fargo Dealer Services For Loan/Lease Payoff $ 15,248.48
B. To EFG Companies For GAP Insurance $
599.00
C. To For $
0.00
D. To For $
0.00
E. To Government Agency For Titling Fees $
33.00
F. To Membership Fee For CU Membership $
15.00
G. To For $
0.00
Total Other Charges (3A through 3G) $ 15,895.48 (3)
4. Amount Financed (1+2+3) $ 15,895.48 (4)
5. Administrative Fee (Prepaid Finance Charge) $ 0.00 (5)
This written loan agreement is the final agreement between you and me and may not be changed by prior, current, or future oral agreements
between you and me. There are no oral agreements between you and me relating to this loan agreement. Any change to this agreement must
be in writing. Both you and I have to sign written agreements. BY SIGNING THIS NOTE I AGREE WITH AND ACKNOWLEDGE RECEIPT
OF THE ABOVE DISCLOSURES AND THE ADDITIONAL TERMS AND CONDITIONS ON PAGE 2&3.
SIGN HERE
CO-SIGN HERE
9/28/2012 9/28/2012
Borrower Signs - Corey Lynn Brown
Borrower Signs -
THIS NOTE CONTAINS AN ARBITRATION PROVISION, WHICH AFFECTS MY RIGHTS.
This is page 1 of a 3 page Note. See next page for additional terms. ORL-NSAR1-KINTX-5.0 04012012

NOTE AND SECURITY AGREEMENT
For your files
Additional Terms and Conditions
Application ID: 257806
INTEREST. The annual rate of interest is 8.49% . Interest will be computed on a daily basis on the unpaid Amount Financed by the simple
interest method. Interest will accrue based upon 365 days in each year. The Finance Charge shown in the Truth in Lending Disclosures may vary
depending upon my payment patterns. Early payments will have the effect of reducing the Finance Charge, while payments made after their
respective due dates will increase the Finance Charge. The amount of my final payment will depend upon the amounts and dates of the payments
I make. If I do not pay all that I owe when the final payment is due, I will pay interest on the amount that is still unpaid at the annual rate of
interest above, but not to exceed the maximum rate allowed by law, until paid.
REPAYMENT. If the original payoff quoted by my previous lender(s) is not enough to satisfy my loan obligation, and my previous lender(s)
requires additional funds to release its security interest, I authorize you to pay such funds on my behalf and to add such amounts to the Amount
Financed. I further authorize you to advance to others amounts necessary, including taxes, fees, charges and other obligations, for you to obtain
and/or maintain a first priority perfected security interest in the Collateral and add such amounts to the Amount Financed. I agree that the amount
of my monthly payment will be adjusted so that the Amount Financed (as adjusted) plus accrued interest figured at the annual rate of interest is
payable in substantially equal monthly payments during the term of this Note.
PREPAYMENT. I may pay the unpaid balance, or any part thereof, of this Note at any time without penalty. If I make a partial prepayment, I
am still required to make the next payment as scheduled. I may not skip payments.
REQUIRED INSURANCE. I must keep the collateral insured against damage or loss in the amount I owe. I may obtain property
insurance from anyone I want or provide proof of insurance I already have. The insurer must be authorized to do business in Texas. The
deductible for any specific coverage shall not exceed $500 and the policy term may not be less than 6 months. I agree to give you proof of
property insurance. I must name you as the person to be paid under the policy in the event of damage or loss. If I fail to meet any of these
requirements, you may obtain Collateral protection insurance at my expense. If you obtain Collateral protection insurance, you will mail notice to
my last known address.
SECURITY INTEREST. To secure the loan evidenced by this Note, I give you a security interest in the “Collateral”. The Collateral includes (i)
the motor vehicle and other goods being purchased including all proceeds of the vehicle and goods; (ii) accessories, equipment and replacement
parts installed in such vehicle; (iii) all insurance, maintenance, service, debt cancellation or debt waiver contracts you finance for me; and (iv)
proceeds, including, without limitation, refunds of premiums and charges, of any insurance, maintenance, service, debt cancellation or debt waiver
contracts you finance for me.
COLLATERAL RESTRICTIONS. I won’t sell or transfer the Collateral without your written permission. I won’t allow anyone else to have an
interest in the Collateral except you. I will keep the collateral at my address shown above. I will promptly tell you in writing if I change my
address. I won’t permanently remove the collateral from Texas unless you give me written permission. I will timely pay all taxes and license fees
on the collateral. I will keep it in good repair. I won’t use the collateral illegally.
DEFAULT. To the extent permitted by applicable law, I will be in default under this Note if any of the following things happen: (1) I fail to
make any payment in full or fail to pay any other charge when it is due; (2) I break any promise, agreement or condition made in the Note or in
any other agreement I have with you; (3) I fail to keep required insurance in force; (4) I give you false or misleading information on my
application or any of the documents I provide or have provided to you; (5) I die, am declared incompetent, become insolvent, or file a bankruptcy
petition, or have a bankruptcy petition filed against me; (6) The Vehicle is destroyed, stolen, damaged beyond repair, seized, confiscated, levied
upon by governmental or legal process; or (7) anything else happens that you reasonably believe in good faith endangers the vehicle or my ability
to pay. If I am in default, you may require me to pay the entire unpaid principal balance, any accrued but unpaid interest and other charges due at
once, subject to any right the law gives me to reinstate this Note. If you do not enforce your rights every time, you can still enforce them later.
REPOSSESSION. If I default under this Note, you shall have all the rights granted to a secured party under the Uniform Commercial Code and
other applicable law. Unless prohibited by applicable law, these rights include, but are not limited to, the right to repossess the Collateral, sell the
Collateral if I fail to redeem it, and deduct from the sale proceeds, as allowed by applicable law, the expenses of retaking, holding, preparing for
disposition, processing and disposing of the Collateral. Unless prohibited by applicable law, I agree to pay your reasonable costs and expenses
arising from repossession and sale of the Collateral. If there is a surplus as a result of the sale, it will be paid to me unless you must pay it to
someone else. To the extent permitted by applicable law, if the money from the sale is not enough to pay all I owe, I must pay the difference,
including accrued interest. I waive the provisions of the California vehicle Code Section 1808.21 and authorize the California Department of
Motor Vehicles to furnish my residence address to you.
MAILING ADDRESS. You can mail any notice to me at my last address in your records. Your duty to give me notice will be satisfied when
you mail it.
COLLECTION COSTS. I agree to pay a fee of fifteen dollars ($15) for the return by a depository institution of a dishonored check, negotiable
order of withdrawal, or share draft. I also agree to pay reasonable attorney’s fees and legal expenses to the extent permitted by applicable law.
MISCELLANEOUS. I promise that all information I gave you is true. The promises in this Note are joint and several. I understand that you
may seek payment from only me without first looking to any other Borrower.
SAVINGS CLAUSES. I don’t have to pay interest or other amounts that are more than the law allows. If any part of this contract is declared
invalid, the rest of the contract remains valid.
APPLICABLE LAW. This Note is governed by the laws of the State of California.
NOTICE TO BORROWERS. This loan is made by OpenRoad Lending, 6616 Davis Blvd, North Richland Hills, TX 76182, and Lender
License File No. 603-I315, pursuant to the California Finance Lenders Law, Division 9 (commencing with section 22000) of the Financial Code.
By entering into this Note, you represent that no person has performed any act as a broker in connection with the making of this loan.
FOR INFORMATION, CONTACT THE DEPARTMENT OF CORPORATION — STATE OF CALIFORNIA.
This is page 2 of a 3 page Note. See next page for additional terms. ORL-NSAR2-KINTX-v5.0 04012012

NOTE AND SECURITY AGREEMENT
Application ID:
For your files
257806
ARBITRATION PROVISION. Upon written request by me or you submitted according to the rules for arbitration, any Claim, except those
specified below, shall be resolved by binding arbitration in accordance with: (i) the Federal Arbitration Act, (ii) the Rules of the chosen
Administrator, and (iii) this Arbitration Provision.
(a) Claims Covered. “Claim” means any claim, dispute, or controversy now or hereafter existing between me and you, including without limitation,
any claims arising out of, in connection with, or relating to this Note, and any modification, extension, application, or inquiry of credit or forbearance
of payment; any trade-in of a vehicle; any products, goods and/or services, including the installation thereof, purchased in connection with this Note;
any insurance, service contract, extended warranty, auto club membership or debt cancellation agreement purchased in connection with this Note; the
closing, servicing, collecting or enforcing of this Note; whether the claim or dispute must be arbitrated; the validity of this Arbitration Provision; any
negotiations between you and me; any claim or dispute based on an allegation of fraud or misrepresentation, including without limitation, fraud in the
inducement of this or any other agreement; and any claim or dispute based on state or federal law, or an alleged tort. You and I also agree to submit to
final, binding arbitration any claim or dispute that you or I have against all persons and /or entities: (i) who are involved with this Note, (ii) who
signed or executed any document relating to this Note or any Claim, and (iii) who may be jointly or severally liable to either me or you regarding any
Claim.
EXCLUSION FROM ARBITRATION. The following types of matters will not be arbitrated: (1) The exercise of extra-judicial or self-help
repossession under applicable law or any action seeking to enforce a security interest or any action to effect the sale or transfer of the property being
foreclosed (collectively “Excluded Actions”). However, any claim or dispute arising out of or relating to the exercise of such Excluded Actions is
subject to arbitration in accordance with this Arbitration Provision; or (2) Any Claim where all parties collectively (including multiple named parties)
seek, in the aggregate, $15,000 or less in total monetary relief, including but not limited to compensatory, statutory and punitive damages, restitution,
disgorgement, and costs and fees (including attorney’s fees); or any Claims brought and maintained as an individual (as opposed to class) action in a
small claims court. If I attempt to assert any Claim on behalf of a putative class of persons, in violation of other terms in this Arbitration Provision,
the value of such Claim will, for purposes of this exclusion, be deemed to exceed $15,000. If any party fails to specify the amount being sought for
any relief, or any form or component of relief, the amount being sought shall, for purposes of this exclusion, be deemed to exceed $15,000.
Participation in a lawsuit or seeking enforcement of this section by a court shall not waive the right to arbitrate.
(b) Commencing Arbitration. The party initiating arbitration must choose one of the following arbitration Administrators and follow the rules and
procedures that govern disputes established by the Administrator (“Rules”). The Administrator shall be the American Arbitration Association, 335
Madison Avenue, New York, NY 10017-4605, www.adr.org, or any other organization that I may choose provided you approve of my choice in
writing. The Rules and a form of demand for arbitration are available from the Administrator. You or I may bring an action, including a summary or
expedited proceeding, to compel arbitration of any Claim, and/or to stay the litigation of any Claim pending arbitration, in any court having
jurisdiction. Such action may be brought at any time, even if a Claim is part of a lawsuit, up until the entry of a final judgment.
(c) Place of Arbitration. Arbitration shall be conducted in the county of my residence, unless all parties agree to another location.
(d) No Class Actions/No Joinder of Parties. Claims and disputes by or on behalf of other persons not a party to this Note will not be arbitrated in any
proceeding considering your Claims. I MAY NOT SERVE AS A CLASS REPRESENTATIVE OR PARTICIPATE AS A MEMBER OF A CLASS
OF CLAIMANTS OR ACT AS A PRIVATE ATTORNEY GENERAL WITH RESPECT TO ANY CLAIM AGAINST ANY PARTY ENTITLED
TO COMPEL ARBITRATION UNDER THIS ARBITRATION PROVISION. This is referred to in this Note as the “class action waiver.”
(e) Governing Law for Arbitration. The Federal Arbitration Act, 9 U.S.C. §§ 1 et seq., shall govern this Arbitration Provision. The arbitrator shall
make his or her decision in accordance with applicable substantive law consistent with the Federal Arbitration Act and applicable statutes of
limitations, and shall be empowered to award any damages or other relief provided for under applicable law. Judgment upon any arbitration award
may be entered in any court having jurisdiction.
(f) Costs of Arbitration. You will advance my filing, administration, service or case management fees and my arbitrator or hearing fee all up to
$2,500, which may be reimbursed by the decision of the arbitrator at the arbitrator’s discretion. Each party shall be responsible for its own attorney,
expert and other fees, unless awarded by the arbitrator under applicable law.
(g) Other Important Agreements. This Arbitration Provision applies even if this Note has been paid in full, charged-off by you, or discharged in
bankruptcy. In the event of a conflict or inconsistency between this Arbitration Provision and the arbitration Rules or the other provisions of this
Note, this Arbitration Provision shall govern.
If the class action waiver above is determined to be unenforceable, void, illegal or otherwise against applicable law, then the remainder of this
Arbitration Provision shall be unenforceable.
Special Acknowledgments. I understand: (i) the Vehicle and other goods, products and services related to this Note, as well as the funding for my
credit transaction, come in whole or in part from sources outside this state, which constitute interstate commerce within the meaning of the Federal
Arbitration Act; and (ii) a court or jury will not hear or decide any Claim governed by this Arbitration Provision.
NOTICE: ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS AND DEFENSES WHICH
THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED WITH THE PROCEEDS
HEREOF. RECOVERY HEREUNDER BY THE DEBTORS SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR
HEREUNDER.
This is page 3 of a 3 page Note.
ORL-NSAR3-KINTX-v4.0 04012012

App ID:257806
MEMBERSHIP APPLICATION
(SHORT FORM)
Complete
Sign
Email/Fax back
PRIMARY ACCOUNT HOLDER INFORMATION
LAST NAME MS. MR. MRS. FIRST NAME & MIDDLE INITIAL SOCIAL SECURITY #
BROWN COREY LYNN 462-51-5102
DRIVER’S LICENSE #/ STATE MOTHER’S MAIDEN NAME DATE OF BIRTH
RESIDENTIAL ADDRESS CITY STATE & ZIP
MAILING ADDRESS CITY STATE & ZIP
HOME PHONE # WORK/DAYTIME PHONE# FAX EMAIL ADDRESS
EMPLOYER (IF RETIRED, FORMER EMPLOYER NAME) SCHOOL/OCCUPATION RETIRED UNEMPLOYED STUDENT
Employed
4/3/1969
1482 Poetry Rd ROYSE CITY TX, 75189
1482 Poetry Rd ROYSE CITY TX, 75189
(214) 354-4238 (903) 873-6600 info@4Bwebdesign.com
R & R MILLWORK
plant manager
EMPLOYER OR SCHOOL ADDRESS EMPLOYER OR SCHOOL PHONE #
> (903) 873-6600
MEMBERSHIP ELIGIBILITY
I AM ELIGIBLE TO JOIN KINECTA PURSUANT TO MY MEMBERSHIP IN THE CONSUMERS COOPERATIVE SOCIETY OF SANTA MONICA, IINC. (SEE ATTACHED APPLICATION.)
A$5.00 minimum savings account deposit is required for membership.
JOINT OWNER INFORMATION
NAME (FIRST, MIDDLE, LAST) MS. MR. MRS. SOCIAL SECURITY # DATE OF BIRTH
STREET ADDRESS DAYTIME PHONE #
EMPLOYER (IF RETIRED, FORMER EMPLOYER NAME)
>
EMPLOYER OR SCHOOL ADDRESS
SCHOOL / OCCUPATION RETIRED UNEMPLOYED STUDENT
EMPLOYER OR SCHOOL PHONE
DRIVERS’S LICENSE # / STATE
BENEFICIARY INFORMATION
Pay-on-Death Provisions: In the event of my/our death, I/WE hereby designate the following beneficiary:
PAYEE RELATIONSHIP DATE OF BIRTH SOCIAL SECURITY #
CERTIFICATION FOR TAXPAYER IDENTIFICATION NUMBER AND ACCOUNT AGREEMENT
A. Certification for Taxpayer Identification: Under penalty of perjury, I certify that: (1) the number on this form reference above is my correct Social Security number/taxpayer
identification number (TIN); (2) I am not subject to backup withholding because : (a) I am exempt from backup withholding; or (b) I have not been notified by the Internal
Revenue Service (IRS) that I am subject to withholding as a result of a failure to report all interest or dividends; or (c) the IRS has notified me that I am no longer subject to
withholding; and (3) I am a U.S. person or resident alien. Note: I must cross out item (2) above if I have been notified by the IRS that I am currently subject to backup
withholding.
B. Account Agreement: I/We agree to conform to the Credit Union by-laws, the terms and conditions of the Application for Membership and Agreements & Disclosures (Share Accounts,
Truth in Savings, and Electronic Services). I hereby apply for membership and I/we authorize Kinecta Federal Credit Union to verify all the information supplied herein and to verify
my/our creditworthiness. Federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account, in order to help the
government fight the funding of terrorism and money laundering activities. What this means for you: When you open an account, we will ask for your name, address, date of birth and
other information that will allow us to identify you. I waive the provisions of California Vehicle Code 1808.21 (or any other state) and authorize the California Department of Motor
Vehicles (or any other state) to furnish my residence address to you. I/We agree that an electronically transmitted copy of this document shall be considered as an original document and
shall be admissible as evidence in any court competent jurisdiction. The Internal Revenue Service does not require consent to any provision of this document other than the certification
required to avoid backup withholding.
SIGN
Co-SIGN
Primary Acct Holder Signature: ________________________________________ HERE Date: ________________ Joint Acct Holder Signature: _____________________________________ HERE Date: _____________
There is a $2 paper statement processing fee per deposit statement (such as checking, savings, or money market accounts). To save this fee, log on to www.kinecta.org to sign up for free and secure online banking and electronic statements.
Kinecta/SM COOP use ONLY
FOR OFFICE USE ONLY
NEW MEMBER NUMBER ___________________________________________________________________
CO-OP NUMBER __________________________________________________________________________
MEMBERSHIP OFFICER APPROVAL _______________________________________________ DATE __________________________________ REP# _________________________________________ OFFICE # ____________________
Page 1
450146B (10/11)

App ID:257806
MEMBERSHIP APPLICATION
(SHORT FORM)
Complete
Sign
Email/Fax back
MEMBER INFORMATION
LAST NAME MS. MR. MRS. FIRST NAME & MIDDLE INITIAL SOCIAL SECURITY #
BROWN COREY LYNN 462-51-5102
DATE OF BIRTH
STREET ADDRESS CITY STATE & ZIP
MAILING ADDRESS CITY STATE & ZIP
4/3/1969
1482 Poetry Rd ROYSE CITY TX, 75189
1482 Poetry Rd ROYSE CITY TX, 75189
HOME PHONE # WORK/DAYTIME PHONE # FAX EMAIL ADDRESS
(214) 354-4238 (903) 873-6600
info@4Bwebdesign.com
JOINT TENANT INFORMATION
NAME (FIRST, MIDDLE, LAST) MS. MR. MRS. SOCIAL SECURITY # DATE OF BIRTH
STREET ADDRESS CITY STATE ZIP DAYTIME PHONE #
DRIVERS’S LICENSE # / STATE
I/We are applying for membership in the Consumers Cooperative Society of Santa Monica, Inc., (Santa Monica Co-Op). I agree to abide by the by-laws
of the Santa Monica Co-Op and to cooperate with the other members in promoting the objectives of the organization as set forth in the by-laws. A copy of
the by-laws is on file at the Consumers Cooperative Society of Santa Monica Inc., 3027 Wilshire Blvd., Santa Monica, California 90403-2301, or visit
www.ccssm.org and click on “Membership.” A description of the Santa Monica Co-Op and its objectives is contained in its brochure, which has been
provided to me (or will be provided by mail).
Membership in the Santa Monica Co-Op may be held as a single person (Single Tenancy) or jointly as joint tenants with Right of Survivorship (NOT as
Tenants-in-Common). If membership is to be held by more than one person, complete all information for both parties. On all memberships:
• Membership becomes effective on receipt of a $10 application fee and acceptance of this application by the Board of Directors.
• Either Joint Tenant, but not both, has the right to vote at membership meetings or by mail ballots.
• Continued membership in the Santa Monica Co-Op will be subject to an Annual Membership Renewal Fee* of $10.00.
I/We agree that an electronically transmitted copy of this document shall be considered as an original document and shall be admissible as evidence in
any court of competent jurisdiction.
I would like to receive all Co-Op member notices in electronic format (e-mail)
SIGN
HERE
Member Signature____________________________________________ Date: _____________________ Joint Tenant Signature: __________________________________________________ Date: __________________________
FOR CO-OP USE ONLY
Co-SIGN
HERE
CO-OP NUMBER ______________________________________
MEMBERSHIP OFFICER APPROVAL ________________________________________ DATE ________________________ REP# _____________________________________________ OFFICE # _________________________
*No annual fee is required to maintain membership in Kinecta Federal Credit Union.
Rev (12/10)
Page 2

OPTIONAL GAP ADDENDUM
CONTRACT NO.
818442578062
Inception Date: 09/28/2012 Account Number: 0000081844
Buyer Name: COREY LYNN BROWN
Address: 1482 POETRY RD
City: ROYSE CITY State: TX Zip: 75189
Protected Vehicle Year/Make/Model: 2008 MAZDA
CX-7-4 CYL TURBO
VIN: (17 Characters) JM3ER293680214658
New Used
Dealer/Seller: OpenRoad Lending
Address: 6616 Davis Blvd. City: NRH
8885363024
State: TX Zip: 76182
Creditor/Assignee: Kinecta
Address: 1440 Rosecrans Ave City: Manhattan Bch State: CA Zip: 90266
FINANCING CONTRACT Amount: $_______ ADDENDUM/FINANCING CONTRACT Term:
15,895.48 51
8.49 ✔
APR ___% Does the FINANCING CONTRACT contain uniform payments? Yes  No
Max. Financing Contract Amount: Autos, SUVs & light trucks: Unlimited All other Collateral: $50,000
Max. Limit of Liability: Autos, SUVs & light trucks: $50,000 All other Collateral: $25,000
Max. Financing Contract Term: 84 Mos. Max. % of Vehicle Value at Inception: 125% Max. Deductible Buyback: $500
months
This GAP protection contract addendum, which is effective as of the inception date above, amends the FINANCING CONTRACT. This addendum is
between the BUYER shown above (YOU or YOUR) and the DEALER/SELLER shown above (WE, US or OUR) or if the FINANCING
CONTRACT is assigned to another party, the ASSIGNEE.
GAP does not take the place of insurance on the PROTECTED VEHICLE. You are responsible for maintaining collision and comprehensive
insurance for the full value of the vehicle and any other insurance required by the FINANCING CONTRACT or applicable law. You are responsible
for all notifications or claims that are required to be filed with your automotive insurance company. We will not process or handle your insurance claims
for you. If you move during the term of this contract, it is your responsibility to notify US or our Administrator of your change of address.
You may wish to consult an alternative source to determine whether similar protection may be obtained and at what cost. If you purchase GAP
from this source, you understand that we may retain all or a portion of the charge for this GAP addendum. You should carefully read the back
of this addendum for additional information on eligibility, requirements, conditions and exclusions that could prevent you from receiving
benefits under this addendum.
LIMITATIONS–THIS IS ONLY A PARTIAL LIST. YOU MUST READ THIS ENTIRE GAP ADDENDUM FOR ALL LIMITATIONS:
A. We will not waive that portion of the UNPAID NET BALANCE that results from the original FINANCING CONTRACT amount exceeding the
Max. % of Vehicle Value at Inception stated above at the inception date of this addendum.
B. FINANCING CONTRACTS with terms greater than the Maximum Financing Contract Term stated above are ineligible.
C. Any addendum issued for an amount financed in excess of A above will be deemed eligible for enrollment as limited by this section.
D. FINANCING CONTRACTS that do not have uniform monthly repayment terms for the full period of the FINANCING CONTRACT are
ineligible.
BY YOUR SIGNATURE BELOW YOU ACKNOWLEDGE AND AGREE TO THE FOLLOWING:
• THAT THIS GAP ADDENDUM IS NOT AN INSURANCE POLICY OR PART OF AN INSURANCE POLICY.
• THAT YOUR ACCEPTANCE OF THIS GAP ADDENDUM IS VOLUNTARY AND IS NOT REQUIRED IN ORDER FOR YOU TO
OBTAIN CREDIT, DOES NOT IMPACT YOUR ABILITY TO OBTAIN ANY PARTICULAR OR MORE FAVORABLE CREDIT
TERMS AND HAS NO EFFECT ON THE TERMS OF THE RELATED SALE OF THIS VEHICLE.
• THAT YOU HAVE READ AND UNDERSTAND THIS ADDENDUM AND ITS PROVISIONS AND AGREE THAT NO VERBAL
REPRESENTATIONS HAVE BEEN MADE TO YOU THAT DIFFER FROM THESE WRITTEN PROVISIONS.
• YOU AUTHORIZE RELEASE OF FINANCING CONTRACT INFORMATION REQUIRED FOR PROCESSING OF A LOSS.
• LOSSES MUST BE REPORTED TO THE BELOW ADMINISTRATOR WITHIN NINETY (90) DAYS OF THE PRIMARY CARRIER’S
SETTLEMENT OR, IF THERE IS NO PRIMARY CARRIER, WITHIN NINETY (90) DAYS OF THE DATE OF LOSS.
Yes, I elect GAP and acknowledge understanding of all provisions above and on succeeding pages.
The Charge for this GAP Addendum is: $________ 599.00
Buyer’s Signature:
Date: _____________
09/28/2012
Buyer’s Signature:
Date: _____________
09/28/2012
Dealer/Seller Signature:
Date:_____________
09/28/2012
Administered by: Enterprise Financial Group, Inc. (EFG) P.O. Box 167667 Irving, TX 75016 800-527-1984
GAP-WAIVER-125% PR TX (10/11) ORL LZX 85432 Page 1 of 3

WE will cancel certain amounts YOU owe under this FINANCING
CONTRACT in the event of a CONSTRUCTIVE TOTAL LOSS or
UNRECOVERED THEFT to the PROTECTED VEHICLE subject to
the LIMITS OF LIABILITY on the reverse side and the terms, conditions
and exclusions hereof. You will remain responsible for payment of any
items stated under Exclusions and that remain unpaid in the FINANCING
CONTRACT.
TERMINATION OF ADDENDUM: This addendum will terminate on
the earliest date that any of the following events occur: 1. the date your
FINANCING CONTRACT is scheduled to terminate; 2. in the event
that the FINANCING CONTRACT is terminated prior to its maturity
date; 3. in the event that a PROTECTED VEHICLE is sold, assigned or
transferred by You before the expiration date of the FINANCING
CONTRACT unless the assignee provides prior written consent; 4.
expiration of any redemption period following the repossession or
surrender of the PROTECTED VEHICLE; or 5. the date the
FINANCING CONTRACT is prepaid or the FINANCING
CONTRACT is refinanced.
YOUR RIGHT TO CANCEL: You may cancel this addendum before
midnight of the 60th day after the inception date shown above and receive a
full refund/credit. In the event of early termination of the addendum after
the 60 th day, provided no loss under this addendum has occurred, any
refund will be calculated on the basis of a Pro Rata refund method unless
other state regulatory methods apply. In the event of acceleration or
demand in full of the FINANCING CONTRACT’s unpaid balance, a
refund calculated as of the date of acceleration or demand in full will be
provided. In the event of the total denial of a debt cancellation request, a
refund calculated as of the date of denial will be provided. We will apply
all refund proceeds to any remaining balance. It is your responsibility to
notify the GAP Administrator shown below, in writing, of your request
to cancel this addendum and request a refund/credit of the GAP
charges. If you do not receive the refund/credit within 60 days of
notice of cancellation/termination, contact the GAP Administrator
shown below.
LIMITS OF LIABILITY
The amount WE will waive under this addendum will be the lesser of:
A. The amount shown as the MAXIMUM LIMIT OF LIABILITY
on Page 1; or
B. If the collateral is protected by a PRIMARY CARRIER; the amount obtained by
subtracting the primary insurance settlement, including any amount that the
primary deductible exceeds the Max. Deductible Buyback reflected on Page 1,
from the UNPAID NET BALANCE. If a portion of the PROTECTED VEHICLE is not
covered by a PRIMARY CARRIER, the ACTUAL CASH VALUE AT LOSS of that
portion and the amount of any unrepaired prior damage or the value of any
retained salvage shall be added to the primary insurance settlement. The total will
then be subtracted from the UNPAID NET BALANCE; or
C. If the PROTECTED VEHICLE is not protected by a PRIMARY CARRIER;
the amount obtained by subtracting the ACTUAL CASH VALUE AT LOSS of
the PROTECTED VEHICLE, reduced by the amount of any prior damage or
retained salvage, from the UNPAID NET BALANCE.
DEFINITIONS
A. FINANCING CONTRACT: The contract which represents the financing
agreement between YOU and US for the purchase of the PROTECTED
VEHICLE, and which sets forth the terms, conditions, inception date and
expiration date of the financing agreement.
B. PROTECTED VEHICLE: The vehicle shown on Page 1. The vehicle shown
on Page 1 must be a private passenger automobile, SUV, light truck of no more
than 12,500 Gross Vehicle Weight Rating (GVWR) or Recreational Vehicle (RV),
which is a motor home. If the vehicle does not meet this definition, a full refund of
the charge for this addendum will be provided.
C. COMMERCIAL PURPOSES: Vehicles used for carrying goods or
passengers for livery or delivery purposes for compensation. COMMERCIAL
PURPOSES shall also include vehicles used for any of the following purposes at
the time of the accident or UNRECOVERED THEFT: security services, police
vehicles and emergency vehicles. Share-the-expense car pools are not considered a
COMMERCIAL PURPOSE under this addendum.
D. VEHICLE VALUE AT PURCHASE: The lesser of (1) the manufacturer’s
suggested retail price, (2) the selling price of the vehicle or (3) the vehicle’s retail
value from the current, at date of purchase or, National Automobile Dealer’s
Association (NADA) guide.
E. PRIMARY CARRIER: The insurance company that: 1) is secured by YOU to
provide physical damage coverage, as required in the FINANCING CONTRACT,
or 2) provides liability coverage to any person who has caused YOUR vehicle to
incur a CONSTRUCTIVE TOTAL LOSS and for which that person is legally
liable. Additionally, the PRIMARY CARRIER shall be any other coverage YOU
may have protecting YOUR interest in the PROTECTED VEHICLE, contingent
upon the failure or absence of YOUR coverage.
F. CONSTRUCTIVE TOTAL LOSS: A loss where the cost to repair or replace
the PROTECTED VEHICLE plus its salvage value would exceed the ACTUAL
CASH VALUE AT LOSS.
G. UNRECOVERED THEFT: A PROTECTED VEHICLE reported as stolen
to both the police and the PRIMARY CARRIER who have made every effort, yet
have failed to find and return the PROTECTED VEHICLE. A PROTECTED
VEHICLE that is confiscated or improperly taken or secreted by YOU, where both
YOUR and the PROTECTED VEHICLE’S whereabouts are not known shall not
be deemed for the purposes of this addendum as an UNRECOVERED THEFT
loss.
H. ACTUAL CASH VALUE AT LOSS: The retail value of the PROTECTED
VEHICLE or any portion thereof with appropriate adjustments for mileage,
optional equipment or unrepaired prior damage. The retail value will be determined
from the current, at DATE OF LOSS, National Automobile Dealers Association
guide.
I. UNPAID NET BALANCE: The amount owed to US by YOU, in
accordance with the terms and conditions of the FINANCING CONTRACT,
resulting from early termination of the FINANCING CONTRACT. This
amount may not include any unearned finance charges, late charges; any
DELINQUENT PAYMENTS; any uncollected service charges; refundable
prepaid taxes or fees; or any other proceeds YOU may duly recover by canceling
insurance coverages, service contracts or warranties or other items added to the
initial FINANCING CONTRACT balance after the inception of the
FINANCING CONTRACT. If two or more pieces of collateral are secured under
a FINANCING CONTRACT, WE will not waive more than the proportionate
share of the total UNPAID NET BALANCE that the balance applicable to the
PROTECTED VEHICLE represents to the total FINANCING CONTRACT
balance.
J. DELINQUENT PAYMENT(S): Any payment, as described in the
FINANCING CONTRACT, which remains unpaid for a period of more than ten
(10) days after the date stated in the FINANCING CONTRACT.
DELINQUENT PAYMENTS will also include any late charges or finance charges
that have accrued due to past due FINANCING CONTRACT payments.
K. DATE OF LOSS: The date on which the actual physical damage or
UNRECOVERED THEFT occurs. If such date is indeterminable, the DATE OF
LOSS shall be the date the PRIMARY CARRIER makes settlement and payment
to You.
L. UNIFORM MONTHLY REPAYMENT TERMS: A repayment schedule
required in the FINANCING CONTRACT such that all of the payments are
consecutive, substantially equal, and monthly. The first payment due date must be
due within one month and 15 days from the effective date of the FINANCING
CONTRACT.
EXCLUSIONS
This addendum does not cover loss or damage:
A. Occurring prior to the effective date of this addendum.
B. In connection with a FINANCING CONTRACT effected prior to the
effective date of this addendum.
C. Resulting directly or indirectly from any dishonest, fraudulent, criminal, or
illegal act or arising from an intentional act committed by YOU.
D. Due to or resulting from mechanical or electrical breakdown or failure.
E. Resulting from the vehicle being operated, used, or maintained in any race,
speed contest or other contest.
F. If the vehicle was ever titled as a salvage or rebuilt vehicle. If loss is excluded
under this exclusion, full refund of the charge for this addendum will be provided.
G. If the FINANCING CONTRACT term exceeds the Maximum FINANCING
CONTRACT Term reflected on the reverse side. If loss is excluded under this
exclusion, full refund of the charge for this addendum will be provided.
H. For vehicles used for COMMERCIAL PURPOSES.
I. For any amounts deducted from the PRIMARY CARRIER’s settlement due to
wear and tear, prior damage, unpaid insurance premiums, salvage, towing and
storage and other condition adjustments.
J. Attributable to other than the standard or optional equipment available
from the manufacturer of the PROTECTED VEHICLE, including but not
limited to: special carpeting, furniture, bars, audio, video or data equipment,
cooking and sleeping facilities, customized paint, or any equipment installed
to overcome a physical handicap. Factory approved conversion packages and
dealer installed options usually included in used car value guidebooks are not
excluded.
K. If YOU intentionally concealed or misrepresented any material fact; engaged in
fraudulent conduct; or made a materially false statement in submitting a potential
loss.
L. Due to UNRECOVERED THEFT, if no police report has been filed.
Administered by: Enterprise Financial Group, Inc. (EFG) P.O. Box 167667 Irving, TX 75016 800-527-1984
GAP-WAIVER-125% PR TX (10/11) ORL LZX 85432 Page 2 of 3

M. If the loss is not reported within ninety (90) days of settlement with the
PRIMARY CARRIER or, should there be no PRIMARY CARRIER, within
ninety (90) days of the DATE OF LOSS.
N. Occurring after the expiration of any redemption period following the
repossession or surrender of the PROTECTED VEHICLE.
O. Occurring to a PROTECTED VEHICLE that is a Recreational Vehicle (RV)
if physical damage insurance from a PRIMARY CARRIER is not effective on the
DATE OF LOSS.
P. If the FINANCING CONTRACT does not schedule uniform monthly
payments throughout its term. If loss is excluded under this exclusion, full refund
of the charge for this addendum will be provided.
CONDITIONS
A. ADDENDUM PERIOD, TERRITORY: This addendum shall be effective for
the term reflected on Page 1, and will only cover losses that occur during the
original FINANCING CONTRACT term of a PROTECTED VEHICLE in the
United States, its territories and possessions or Canada.
B. MITIGATION OF LOSS: YOU should do all things reasonable and practical
to avoid or reduce any loss under this addendum and to protect the PROTECTED
VEHICLE from any further loss. YOU should also take reasonable measures to
ensure that the maximum amount of actual cash value of a PROTECTED
VEHICLE is paid by the PRIMARY CARRIER. Any loss due to YOUR
failure to protect the vehicle or maximize settlement from the PRIMARY
CARRIER shall not be recoverable under this addendum.
C. DECLARATIONS: By accepting this addendum, You acknowledge the
agreements and representations in the addendum and agree that this addendum is
issued based upon the truth of such representations.
D. ASSIGNMENT: This GAP addendum will follow the FINANCING
CONTRACT with no subrogation rights against the Buyer, if the FINANCING
CONTRACT is sold or assigned by the DEALER/SELLER. This addendum shall
not be assigned, ceded or transferred by YOU unless the assignee provides prior
written consent.
COMPLAINTS: YOU may file a complaint with the Texas Office of
Consumer Credit Commissioner located at 2601 N. Lamar Blvd.,
Austin, TX 78705. Their phone number is 800-538-1579 and their
website is http://www.occc.state.tx.us
LOSS DOCUMENT REQUIREMENTS: YOU shall report any potential loss to the administrator shown on the front of this addendum within ninety
(90) days of settlement with the PRIMARY CARRIER or, should there be no PRIMARY CARRIER, within ninety (90) days of the DATE OF
LOSS. For each loss YOU must provide the following: 1) a copy of the primary insurance settlement worksheet and check; 2) verification of any other
insurance or other recoverables (including sale of salvage) and any other refundable amounts; 3) a copy of this GAP addendum; 4) verification of the
primary insurance deductible and the date of loss; 5) a copy of the police report, in the case of an UNRECOVERED THEFT; 6) a copy of the
FINANCING CONTRACT, payment history and calculation of UNPAID NET BALANCE amount.. No amount shall be waived by US if the loss is
not reported or if the documentation is not provided within the stated time period. With reasonable advance notice, WE may request to inspect the
PROTECTED VEHICLE. YOU will not be required to provide additional documentation not listed in this addendum to substantiate the
CONSTRUCTIVE TOTAL LOSS or UNRECOVERED THEFT to determine the amount of debt to be waived All amounts waived shall be applied
to the FINANCING CONTRACT balance within thirty (30) days after satisfactory presentation and acceptance of all information listed above. Loss
processing will not be made until YOU have recovered all amounts from any insurance or other indemnity which is valid and collectible and from any
other recoverable or refundable source.
Administered by: Enterprise Financial Group, Inc. (EFG) P.O. Box 167667 Irving, TX 75016 800-527-1984
GAP-WAIVER-125% PR TX (10/11) ORL LZX 85432 Page 3 of 3