Buyer Affirmations
Buyer/Borrower Name:
Co‐Buyer/Co‐Borrower Name:
Seller/Dealer Name (“Dealer”):
Date of Retail Installment Sales Contract (“Contract”):
Vehicle Year, Make, Model, and VIN (“Vehicle”): __________________________________________
By signing below, I affirm the following concerning the purchase of the above‐referenced Vehicle:
1. I was given an opportunity to read the Contract, confirmed it was completely filled in with
no omissions, and have asked any questions I have regarding the Contract prior to signing it.
2. I confirm the cash price of the Vehicle stated in the Contract. I represent that I was not quoted
a lower cash price to purchase the Vehicle, and the cash price was not increased in order for
me to finance the purchase of the Vehicle.
3. I understand that I am not required to purchase any ancillary product (such as credit
insurance, service or warranty contracts, key replacement service, motor club membership,
GAP protection, or any other ancillary product(s) which may be shown on the Contract) as a
condition of purchasing the Vehicle or obtaining credit. If the Contract contains charges for
such products, I have voluntarily agreed to buy them, and I understand that the Dealer and/
or others may profit from the sale and/or financing of these products. I acknowledge receipt
of this disclosure orally and in writing before signing the Contract.
Buyer/Borrower Signature
Co‐Buyer/Co‐Borrower Signature
Date
Buyer Affirmations – LD Rev. 2014.09.26
961 East Main Street
I Spartanburg, SC 29302 I 866-202-6916 I www.americancreditacceptance.com