Rent to Own Agreement Date ________________Store Acct#__________ Contact us at (708) 798-5500/ melodymartusa.com/ [email protected] Full Name of Lessee:________________________________ Home Phone: ( ) ___________________ D.L.# ________-_________-_________ Cell Phone: ( ) ___________________ S.S.# ________-_______-___________ Email: __________________________________________ Address: ________________________________ City: ___________________ St: _____ Zip: __________ Employer: ________________________________________ Work Phone ( ) ___________________ Spouse’s Full Name: ____________________________ Spouse’s Phone ( Spouse‘s Employer: ________________________ Spouse’s Work Phone ( Nearest Relative: _____________________________ Relative’s Phone ( Student’s Name: School: Item Rented: ________________________________ Tax: ______________ Total Price: _____________        ) ___________________ ) ___________________ ) ___________________ I hereby deposit the sum of $ _________________ (Initial Rent plus Maintenance Charge) I agree as long as I keep the instrument to pay the further sum of $ _____________on the ________ day each month commencing __________________ 20 ____ All monthly rental prices include a maintenance charge $__________. All repairs must be done by Melody Mart Inc. 1. You will have sole responsibility of the cost of repairs to instrument caused by negligence or abuse. We reserve the right to refuse to lease an instrument to anyone with incomplete credit information. All payments that are more than 30 days past due will not be applied toward purchase of rented instrument. Melody Mart reserves the right to terminate rental agreement if customer moves or changes the home address. No refunds for early returns. After initial rental you have the following options: 1. Continue to re-rent the instrument on a continuous monthly basis accumulating money toward the rent-to-own price. 2. Purchase the instrument in one payment at any time and receive a discount on the unpaid balance. 3. Return the instrument at any time. (see conditions on second page) If an active checking/Savings account is not provided to Melody Mart for monthly ACH payments and Melody Mart chooses to honor this agreement, a $ 25.00 monthly processing fee will be included in addition to monthly payment. (circle one) SECURITY INFORMATION REQUIRED FOR RENTAL Name on Card _____________________________________________ If credit card information is not given with rental, a deposit of $ _____________ will be required. This information will be used to obtain any delinquent Payments or monies owed on account. _______ ACH (Automatic Cash withdrawal from Checking Acct.) Customer’s Initials I hereby authorize Melody Mart, Inc. Or it’s agent to initiate debit entries to my checking account indicated below. In the event any payment under this contract is not made in a timely manner, I hereby authorize Melody Mart, Inc. to debit my checking account for the amount of the payment plus applicable charges. Initial Rental $ _____________ Initial Maintenance $ ______________ ________________ $ ______________ Deposit $ _____________ SUB TOTAL $ _____________ Accessories Music Book Music Stand Tax SUB TOTAL MC VISA AMX DISCOVER Card # ___________________________________________________ Exp Date _______________________Security Code ______________ Signature of Card Holder _____________________________________ MONTHLY DEBIT DATE _____5th,_____12th, _____20th, _____30th Bank Name _________________________________ RT# __________________________________________ ACCT# __________________________________________ $ $ $ $ $ _____________ _____________ _____________ _____________ _____________ TOTAL $ ___________ Payment Method ________________ Please do not sign this contract before you have read the entire contract including any writing on the second page. Please retain a copy of this contract. You will not receive an instrument until this agreement has been filled out completely. Lessee (Parent/Renter) Signature __________________________________________________Date__________ TERMS/CONDITIONS OF THIS AGREEMENT RENTAL PAYMENTS 1. You agree to make all payments in advance of each rental period. These payments are not contingent on practice or lesson schedules. We will consider as delinquent all payments that are received 15 days past due and you will incur a late charge (20% of payment). All rental payments less Maintenance service charge will be applied toward the purchase of the instrument if rented on a continuous monthly basis. There will be a $25 fee for any returned check or Auto Check Debiting NSF. REPAIRS 2. All repairs must be done only by Melody Mart Inc. You will have sole responsibility to pay for the cost of repair if there is damage resulting from negligence or your failure to properly care for your instrument. Coverage is excluded for reeds, mouthpieces, valve or slide oil, strings, bridge, or bow. STRING INSTRUMENT RENTALS 3. Smaller string instruments are traded up to larger ones as a child grows. Smaller instruments are not usually the one a customer will eventually purchase. Your payment, less service charge, will go towards a full-size string instrument. SWITCHING TO A DIFFERENT TYPE OF INSTRUMENT 4. If you decide to switch instruments, monthly rental payments may change depending on the instrument. The purchase price may also change depending on instrument. A $20.00 exchange fee will be charge at the time of switch. PURCHASE INFORMATION 5. The instrument shall remain ours until it has been paid for in full. You have the option to purchase the instrument at any time during the rental (if you are not in default of this contract). If you exercise this option, the price you pay will be the list price of the instrument plus any applicable taxes and you will receive a credit for the total of your monthly payments, exclusive of monthly maintenance service charges. Once your monthly payment exclusive of monthly maintenance service charges equals the list price plus applicable taxes, you will gain title of the instrument and our mutual obligations under this agreement will cease. You are entitled to a discount if you purchase the instrument outright before the expiration of the rental. You may call Melody Mart Inc. for information about discounts. RETURNING YOUR INSTRUMENT 6. You may return the instrument at any time to terminate this agreement. There are no refunds for early returns. You must return the instrument to Melody Mart Inc. If the instrument is damaged or defective when returned, you may have to pay additional fees for the repair of the instrument. When the instrument is returned, you must pay any outstanding amounts. If the instrument is returned, all monies toward the purchase of the instrument will be forfeited. If you file any form of Bankruptcy, you must return the rented instrument to Melody Mart Inc. Immediately. Under no circumstances do you have the right to keep the instrument. INFORMATION ON BREACH OF THIS AGREEMENT 7. If you are in default of this agreement your delinquent payments, service charges, and all future payments shall immediately become due. You will be in default of this contract if: A. (1) You fail to make a timely payment to Melody Mart Inc. (2) Your check or Auto Check payment is non-collectible. (3)You fail to notify Melody mart of a change in your address or phone number in writing. (4) You damage the instrument through negligence or fail to properly care for it. (5) You lose the instrument including fire or theft. (6)You fail to return the instrument. (7) You allow anyone other than Melody Mart Inc. to service the instrument. (8) You sell, assign, or attempt to sell or assign the instrument. (9) You declare bankruptcy. B. If you are in default of this agreement, we may terminate this agreement with you. If you owe us money that has remained unpaid for more than 60 days, and we send this obligation to collection, all payments along with collection and legal fees associated with these actions will be due. If you are still in the possession of the instrument at the time you are sent to collection you will be responsible for the price of the instrument plus all costs including the collection and legal fees associated with these actions. Return of the instrument as credit toward this obligation will no longer be accepted and we will report promptly to the credit bureau. Title and right of Possession of the instrument shall remain with Melody Mart unless Lessee chooses to buy. At that time, ownership will be transferred to Lessee. C. If rental payments are not paid when due, Melody Mart shall have the right to take possession of the instrument. Lessee does not have any right to sell or sublease rental instrument. In the event that the rental payments become past due by 60 days or more, Melody Mart will consider the Lessee in default of the Agreement and the entire balance of payments owed will become due upon demand. The Lessee retains the right to terminate this agreement at any time by returning the instrument to Melody Mart. Upon returning, all payments must be current and all payments shall be considered rental monies. I have read and understand the Terms/Conditions of this agreement Please retain a copy of this contract. You will not receive an instrument until this agreement has been filled out completely. Lessee (Parent/Renter) Signature __________________________________________________Date_________