Mr. Bail Payment Plan Promissory Note

MR. BAIL PAYMENT PLAN PROMISSORY NOTE

Amount *

Date: *

City/Town/County *

On demand, for value received, the undersigned, jointly and severally if more than one, promise to pay to the order of Mr. Bail Inc. (Agency) and/or Universal Fire & Casualty Insurance Company (Company) with interest thereon at a rate of (10%) ten percent, per annum from call date until fully paid. Interest payable semi-annually. The marker(s) and each endorser (if any) of this contingent promissory note agrees to waive demand, a notice of nonpayment, and protest; and in case suit shall be brought for the collection hereof, or the same has to be collected upon demand of any attorney, to pay reasonable attorney’s fees and assessable costs, for making such collection.
Deferred interest payments to bear interest from maturity at (10%) ten percent, per annum, payable semi-annually.

To the Indemnitor(s) for:

(Defendant/Principal)

Power#:

Payment Schedule

Premium Balance of $

shall be due in full on or before *

Payment Amount

to be paid on a

Weekly
Biweekly
Monthly
Bimonthly

Payments begin on *

and continue, until paid in full.

Special Payment Agreement :

(FULL PAYMENT WILL BE DUE ON DEMAND IF ANY BREACH OF THIS PAYMENT PLAN SCHEDULE)

Defendant/Indemnitor’s Print Name: *

Defendant/Indemnitor’s Signature: *

Indemnitor’s Print Name: *

Indemnitor’s Signature: *

State Of: *

County or City Of: *

Signed, Sealed and Delivered Date: *

Witness Name *

First

Last

Personally known to me or proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed within this instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity (ies), and that by his/her/their signature(s) on the instrument is the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

Notary Public:

My Commission Expires: