MARVIN MANDEL, Governor                             563

OTHER WRITTEN NOTICE, OR SEND A TELEGRAM, TO

(NAME OF SELLER)_____, AT (ADDRESS OF SELLER'S

PLACE OF BUSINESS)______ NOT LATER THAN MIDNIGHT OF

(DATE)
I HEREBY CANCEL THIS TRANSACTION.

(DATE)

(BUYER'S SIGNATURE)

(3)         FAIL, BEFORE FURNISHING COPIES OF THE "NOTICE
OF CANCELLATION" TO THE BUYER, TO COMPLETE BOTH COPIES BY
ENTERING THE NAME OF THE SELLER, THE ADDRESS OF THE
SELLER'S PLACE OF BUSINESS, THE DATE OF THE TRANSACTION,
AND THE DATE, NOT EARLIER THAN THE THIRD BUSINESS DAY
FOLLOWING THE DATE OF THE TRANSACTION, BY WHICH THE BUYER
MAY GIVE NOTICE OF CANCELLATION;

(4)         INCLUDE IN ANY DOOR-TO-DOOR SALES CONTRACT OR
RECEIPT ANY CONFESSION OF JUDGMENT OR WAIVER OF ANY OF
THE RIGHTS TO WHICH THE BUYER IS ENTITLED UNDER THIS
SECTION, INCLUDING SPECIFICALLY HIS RIGHT TO CANCEL THE
SALE IN ACCORDANCE WITH THE PROVISIONS OF THIS SECTION;

(5)       FAIL TO INFORM THE BUYER ORALLY, AT THE TIME HE
SIGNS THE CONTRACT OR PURCHASES THE CONSUMER GOODS OR
CONSUMER SERVICES, OF HIS RIGHT TO CANCEL;

(6)       MISREPRESENT IN ANY MANNER THE BUYER'S RIGHT TO
CANCEL;

(7)      FAIL OR REFUSE TO HONOR ANY VALID NOTICE OF
CANCELLATION BY A BUYER AND, WITHIN 10 BUSINESS DAYS
AFTER THE RECEIPT OF THAT NOTICE, TO:

(i)        REFUND ALL PAYMENTS MADE UNDER THE

CONTRACT OR SALE;

(ii)           RETURN, IN SUBSTANTIALLY AS GOOD

CONDITION AS WHEN RECEIVED BY THE SELLER, ANY GOODS OR
PROPERTY TRADED IN;

(iii) CANCEL AND RETURN ANY NEGOTIABLE

INSTRUMENT EXECUTED BY THE BUYER IN CONNECTION WITH THE
CONTRACT OR SALE AND TAKE ANY ACTION NECESSARY OR
APPROPRIATE TO TERMINATE PROMPTLY ANY SECURITY INTEREST
CREATED IN THE TRANSACTION;

(8)         NEGOTIATE, TRANSFER, SELL, OR ASSIGN ANY NOTE