Page 2. This frame shows an image of a model form for Federal Consumer Leasing Act nonsegregated disclosures. The blanks are not filled in. Circled numbers link certain terms used in the form to explanations. A narrative description of the page follows. Some terms are linked to explanations.

18[The following provisions are the nonsegregated disclosures required under Regulation M.]

19 Description of Leased Property
Year Make Model Body Style Vehicle ID #
     

20 Official Fees and Taxes. The total amount you will pay for official and license fees, registration, title, and taxes over the term of your lease, whether included with your monthly payments or assessed otherwise $____ .

21 Insurance. The following types and amounts of insurance will be acquired in connection with this lease: ____ .
____ We (lessor) will provide the insurance coverage quoted above for a total premium cost of $____ .
____ You (lessee) agree to provide insurance coverage in the amount and types indicated above.

22 Standards for Wear and Use. The following standards are applicable for determining unreasonable or excess wear and use of the leased vehicle: ____

23 Maintenance.
[You are responsible for the following maintenance and servicing of the leased vehicle: ____ ].
[We are responsible for the following maintenance and servicing of the leased vehicle: ____ ].

24 Warranties. The leased vehicle is subject to the following express warranties: ____ .

25 Early Termination and Default. (a) You may terminate this lease before the end of the lease term under the following conditions: ____ .
The charge for such early termination is: ____ .
(b) We may terminate this lease before the end of the lease term under the following conditions: ____ .
Upon such termination we shall be entitled to the following charge(s) for: ____ .
(c) To the extent these charges take into account the value of the vehicle at termination, if you disagree with the value we assign to the vehicle, you may obtain, at your own expense, from an independent third party agreeable to both of us, a professional appraisal of the ____ value of the leased vehicle which could be realized at sale. The appraised value shall then be used as the actual value.

26 Security Interest. We reserve a security interest of the following type in the property listed below to secure performance of your obligations under this lease: ____

27 Late Payments. The charge for late payments is: ____

28 Option to Purchase Leased Property Prior to the End of the Lease. [You have an option to purchase the leased vehicle prior to the end of the term. The price will be [$ ____ /[the method of determining the price] .] [You do not have an option to purchase the leased vehicle.]