“Rental-Purchase Agreement

1.

Lessor(s):

Lessee(s):

2.

Description of Rental Property:

Item

Quantity

Number

Cash Price: ____________________

3.

Total Initial Payment:

Rental Payment:

$_______________

Delivery Charge:

$_______________

Tax:

$_______________

Other (specify):

$_______________

Total:

$_______________

4.

Rental Payments:

Total Weekly Rental Payment:

____________________ (includes tax)

Total Monthly Rental Payment:

____________________ (includes tax)

5.

Other Charges:

In Home Pick-up Fee:

$__________

Reinstatement Fee:

$__________

Other (specify):

$__________

6.

Total Cost To Acquire Ownership:

If you renew this rental agreement each week/month, for __________ weeks/months, you will pay a total of $__________ to own the rental property. This amount includes your total initial payment but does not include other charges such as damage, reinstatement or pick-up fees for which you may be liable.

7.

Cost of Lease Services:

The cost of lease services is the difference between the final purchase price of the rental property and the cash price of the rental property. The cost of lease services for the rental property is $__________.

8.

No Ownership Until Total Paid:

You will not acquire ownership of the rental property until you pay the total rental payments necessary to acquire ownership, or unless you exercise an early purchase option.

9.

Early Purchase Option:

You may purchase the rental property at any time after your first rental payment.

10.

Maintenance:

We (lessor) are responsible for maintaining the rental property in good working condition while it is being rented. We will provide all necessary service, repair or replacement (specify if in home or in store) if you notify us by phone or mail that service is needed. We will not be responsible for repairs done by anyone other than us.

11.

Warranty:

If allowed by the manufacturer, the manufacturer's express warranty covering the rental property rented under this agreement will be transferred to you if, and at the time, you acquire ownership of the rental property.

12.

Damages:

You (lessee) are entirely responsible for loss, damages, theft or destruction of the rental property while it is in your possession. Your liability for such damage will not exceed the early purchase option price of the rental property as of the date it is lost, stolen, damaged or destroyed.

13.

Termination:

You (lessee) may terminate this agreement without penalty at the end of any weekly or monthly term by returning the rental property to us in good condition. You will be liable for any unpaid rental payments due upon the date of return.

14.

Reinstatement:

If you (lessee) fail to make a timely payment, you may reinstate the agreement without penalty, if:

1)

You pay all past due rental charges and a reinstatement fee within 2 days (weekly renters) or 5 days (monthly renters) of your renewal date; or

2)

You return or voluntarily surrender the rental property within 2 days (weekly renters) or 5 days (monthly renters) of your renewal date. If you choose to reinstate the agreement after returning the rental property, you will have up to 21 days (or longer depending on how long you have rented the rental property) to pay all past due rental charges, a reinstatement fee and a reasonable redelivery fee if we deliver the rental property.

I have read the above disclosures before signing this rental-purchase agreement.

Lessee(s):

_________________________

_________________________.”