Promissory Note Check Sheet Page 2

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PROMISSORY NOTE (UNSECURED)
Submit this original signed form, along with the PROMISSORY NOTE CHECK SHEET, via overnight mail to:
Genworth Mortgage Insurance, 8325 Six Forks Rd., Raleigh NC 27615, Attn: MISSO/Delegated Workouts.
Date:
_____________________________________
Certificate No.: ________________________________
Payee: Genworth Mortgage Insurance Corporation
Makers:
_____________________________________
Payee Address:
_____________________________________
Genworth Mortgage Insurance Corporation
City and County Where this
8325 Six Forks Road
Note is Signed: ________________________________
Raleigh, NC 27615
Attn: MISSO/Delegated Workouts
Mailing Address of Makers:
_____________________________________
_____________________________________
_____________________________________
Principal Amount: _____________________
NON-INTEREST BEARING NOTE:
Annual Percentage Rate Finance Charge
Amount Financed
Total of Payments
The cost of my yearly
The dollar amount the
The amount of credit
The amount I will have
credit as a yearly rate
credit will cost me
provided to me or on my
paid after I have made all
behalf
payments as scheduled
MY PAYMENT SCHEDULE WILL BE:
Number of Payments
Amount of Payments
When Payments are Due
First day of each month, commencing
Final or
Final payment due
Payment
1. Promise to Pay. In consideration of Payee approving a workout, maker promises to pay to the order of
Payee or its Assigns, at the place for payment and according to the terms of payment, the principal
amount. All unpaid amounts shall be due by the final scheduled payment date.
2. Security. This loan is unsecured.
3. Prepayment. The Maker of this Note reserves the right to prepay prior to maturity all or any part of the
principal of this Note without penalty.
4. Continuation of Rights. If I make a partial or late payment or mark a payment Paid-in-Full and it is
accepted, the Payee will still have its legal right concerning my repayment of this Note or any other note.
I will remain obligated to repay this Note or any other note that replaces it, even if any other party to this
Note is no longer obligated. Any legal rights that the Payee has will not be given up even if the rights are
not used immediately.
5. Default. This Note shall be in Default if any payment shall be received more than ten (10) days after the
due date.
(page one of two)
6627527.0611

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