Original Contract

Payment History

Recovery Order

Notice of Intent to Dispose

Sales Receipt for reselling vehicle after recovery

Kelly Blue Book Wholesale Price / Print from WEB

Relevant Attached Receipts

Other expense to write in (                                                                                            )

Contract Balance

$

Unpaid Late Fees

$

Repossession Expense

$

Storage Expense

$

Reconditioning Expense

$

Towing Expense

$

Skip Expense

$

Court filing expense

$

Process service

$

(Other)

$

(Other)

$

                                                                       TOTAL EXPENSE

         $

                                                       Proceeds from sale of vehicle

         $

                                   Deficiency Balance plus court related cost

         $