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SEARS REVOLVING CHARGE

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SEARS, ROEBUCK AND CO.

In consideration of your selling merchandise to me on SEARS

REVOLVING CHARGE PLAN, I agree to the following regarding

all purchases made by me or on my SRC identification:

1.

I have the privilege of a 30-day charge account, in which

case I will pay the full amount of all merchandise purchased

with in 30 days from the date of each billing statement.

2. If I do not pay the full amount for all merchandise pur–

chased within 30 days from the date of each billing state–

ment, the following terms sha

11

be in effect:

(AJ I will pay the time sale price for each item purchased

consisting of :

(lJ The cash sale price, and

(2J An amount of time price differential computed at

1112%of each monthly balance, until the full amount

of all purchases and time price differential thereon

are paid in full.

(BJ I will pay for the merchandise purchased in monthly

instalments which shall be computed according to the

following schedule:

NAME

If the unpaid

balance is:

$ .01 -$ 10.00

10.01 - 100.00

100.01 - 150.00

150.01 - 200.00

200.01 - 250.00

250.01 - 300.00

300.01 - 350.00

Over $350.00

The scheduled monthly

payment will be:

BALANCE

$10.00

15.00

20.00

25.00

30.00

35.00

1/ 10 of account balance

I will pay each monthly instalment computed

according to the schedule at left within 15 days

after the date of each statement. If I fail to pay

any instalment in full when due, at your option

the full balance shall become immediately due.

(CJ You are to send me a statement each month

which will show the unpaid balance for merchan–

dise purchased, your time price differential

thereon , and the amount of the monthly instal–

ment coming due.

(DJ I have the right to pay in advance.

ACCEPTED:

SEARS, ROEBUCK AND CO.

(CUSTOMER 'S SIGNATURE )

(DATE )

Print names of other members of family

authorized to buy on your account.

(PLEASE PRINT)-------------------------

Duplicate identification will be issued.

APPROX.

WHAT

PREVIOUS SEARS ACCOUNT_ ______DATE_______,.MOUNT_____STORE?_______________

NUMBER OF

AGE?_______________,..ARRIEO?_ ___________,OEPENDENTS?____________

HOW LONG AT

PRESENT ADDRESS?__________OWN

D

RENT

D

BOARD

D

PHONE NO.,_______________

FORMER-ADDRESS (IF LESS THAN

HOW

2

YEARS AT PRESENT ADDRESS)---------------------------'LONG?_________

WEEKLY

HOWLONG?________OCCUPATION?_____________________EARNINGS________

FORMER EMPLOYER

HOW

(IF LESS THAN

J

YR. WITH PRESENT EMPLOYERJ--------------------LONG?_________

CHECKING

D

NAME AND ADDRESS OF BANt<.____________________________SAVINGS

D

NAME AND ADDRESS

BUSINESS REFERENCES

NAME AND ADDRESS

The information above will be kept strictly confidential

298

SEARS

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