ALLY NOTED HEREIN SUB TOTAL $ i 1 ;-, 4-.i i i Extended Service Agreement $ PURCHASE UNIT LIEN HOLDER Name Pre-Paid Maintenance $ ri / /t Theft Guarantee $ "I/Ea Address Total Accessories $ (112A. City SUB TOTAL $ 1 i 6h1 •" r State Zip Less Trade Allowance $ f 1,i.A. SPECIAL INSTRUCTION