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Case Number: CACE-19-021597 Division: 08
Filing # 97493368 E-Filed 10/18/2019 09:45:14 AM
IN THE CIRCUIT COURT OF THE 17TH
JUDICIAL CIRCUIT IN AND FOR
BROWARD COUNTY, FLORIDA
TROPICAL FINANCIAL CREDIT UNION CASE NO.:
Plaintiff, CIVIL DIVISION
vs.
KEVIN JAY FLATOW
Defendant.
/
COMPLAINT
The Plaintiff sues the Defendant and alleges the following:
1 This is an action for replevin and money damages which is within this Court's
jurisdiction.
2. Plaintiff is a Federal Credit Union.
3 The Defendant is a resident of BROWARD County, Florida, or the Defendant
signed the agreements that are the subject matter of this action while residing in BROWARD
County, Florida.
4 All conditions precedent have been performed or have been otherwise waived.
5 On November 26, 2018, the Defendant executed and delivered a security agreement
(the “Contract”) to the Plaintiff, or its predecessor, securing the purchase of a 2015 INFINITI Q50
(the “Vehicle”).
6. Plaintiff is the owner and holder of the Contract which is attached to this complaint
as Exhibit “A.”
7 The Defendant has failed to pay the full payment due on February 10, 2019 and
each installment thereafter, and Plaintiff has elected to accelerate payments due under the
Promissory Note.
IMPORTANT NOTICE TO CONSUMER DEBTORS
THIS LAW FIRM MAY BE DEEMED A DEBT COLLECTOR UNDER THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT.
THIS IS AN ATTEMPT TO COLLECT A DEBT, ANY INFORMATION PROVIDED WILL BE USED FOR THAT PURPOSE.
#** FILED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 10/18/2019 09:45:11 AM.*###*
8 There remains a balance due under the Contract in the amount of $25,386.55, with
interest since January 10, 2019.
COUNTY I - REPLEVIN
9 Plaintiff re-alleges paragraphs 1 through 8 incorporated herein by reference.
10. This is an action to recover possession of personal property, the Vehicle.
11. To Plaintiff's best knowledge, information and belief, the value of the Vehicle is
$13,700.00 and is located at 11550 SW 26TH STREET, APT #4-110, MIRAMAR, FL 33025.
12. Plaintiff is entitled to possession of the Vehicle by virtue of the Contract. See
Exhibit “A.”
13. The Vehicle is wrongfully detained by the Defendant who entered into the Contract
with Plaintiff in order to obtain possession of the Vehicle.
14. The Defendant came into possession of the Vehicle by purchase through a dealer.
15. The Vehicle has not been taken for any tax, assessment or fine pursuant to law, nor
has it been taken under an execution or attachment against Plaintiff’s property, or if so taken, that
it is by law exempt from such taking by the following reference to the exemption law relied upon.
WHEREFORE, Plaintiff demands final judgment of possession and damages against the
Defendant, including interest and any costs authorized by law.
COUNT Il —- CONVERSION
16. Plaintiff re-alleges paragraphs 1 through 8 incorporated herein by reference.
17. Defendant converted to Defendant’s own use the Vehicle which is pledged as
security to Plaintiff pursuant to the Contract.
WHEREFORE, Plaintiff demands judgment for damages against the Defendant in favor
of Plaintiff.
IMPORTANT NOTICE TO CONSUMER DEBTORS
THIS LAW FIRM MAY BE DEEMED A DEBT COLLECTOR UNDER THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT.
THIS IS AN ATTEMPT TO COLLECT A DEBT, ANY INFORMATION PROVIDED WILL BE USED FOR THAT PURPOSE.
COUNT Ill —- BREACH OF CONTRACT
18. Plaintiff re-alleges paragraphs 1 through 8 incorporated herein by reference.
19. The Defendant breached the Contract by failing to pay the full payment due on
February 10, 2019.
20. There remains a balance due under the Contract in the amount of $25,386.55, with
interest since January 10, 2019.
21. Pursuant to the terms of the Contract, the Defendant is obligated to pay attorney's
fees and costs and that the Plaintiff is obligated to pay its attorney a reasonable fee.
WHEREFORE, Plaintiff demands the following:
A Judgment for damages against the Defendant in favor of the Plaintiff in the
amount of $25,386.55;
B Award of costs of collection and reasonable attorney's fees, late charges
and interest pursuant to the Contract; and
C Any other further relief as the Court may deem fit.
Dunn Law, P.A.
Counsel for Plaintiff
66 West Flagler Street, Suite 400
Miami, Florida 33130
Phone: (786) 433-3866
Fax: (786) 260-0269
joshua.kligler@dunnlawpa.com
By: /s| Geahua C Kigler
Joshua C. Kligler, Esq.
Fla. Bar No. 69397
IMPORTANT NOTICE TO CONSUMER DEBTORS
THIS LAW FIRM MAY BE DEEMED A DEBT COLLECTOR UNDER THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT.
THIS IS AN ATTEMPT TO COLLECT A DEBT, ANY INFORMATION PROVIDED WILL BE USED FOR THAT PURPOSE.
SIE
Tropical Financial Credit Union LOAN APPLICATION
P.O. Box 829517 - Pembroke Pines, Florida 33082-9917
(888) 261-8328 FAX: (954) 499-6748
tarried Applicants may apply for a separate account. Check the appropriate box to indicate Individual Credit or Joint Credit.
individual Credit: Complete Applicant sections if only the applicant's income is considered for loan approval.
Complete Applicant and Co-Applicant sections: (1) if you are relying on income from alimony, child support, or separate maintenance
‘or on the Income or assets of another person as the basis for repayment of credit requested; (2) If you reside In a Community Property
State; (3) if you are rolying on property loceted in a Community Property State as a basis for rapayment of the credit requested; or (4) if
you are an Alaska resident subject to a community property agreement or community property trust. Community Property States include:
AZ, CA, ID, LA, NM, NV, TX, WA, Wi.
CD vont Greait: Complete Applicant and Co-Applicant sections if your co-applicant will be contractually liable for repayment of the loan and Initial below:
We intend to apply for joint credit. (Applicant initials) (Co-Applicant Initials)
PLEASE CHECK BELOW TO INDICATE THE TYPE OF ACCOUNT(S) AND TYPE OF CREDIT FOR WHICH YOU ARE APPLYING.
Ei] Auto [Personal Line of Credit [1] Savings Secured Credit Line Credit Cards: [] Mastercard® Platinum [[] Mastercard® Platinum Secured
Ci Mastercad® Platinum Rewards
Certificate Secured [] Recreational Vehicle
CD Other Loan Request. OMastercard® Platinum Elke
Account/Loan: [individual T)Joint Account: CD) Individual Dvoint
(including ATid/Debh Card Access to the Account if Available) Number of cards requested:
Amount Requested $ 27,000.00 [1 Authorized User Requested (Separate form to be provided)
Purpose/Collateral:; PURCHASE
SEE SEPARATE IMPORTANT CREDIT CARD DISCLOSURE
APPLICANT |[] CO-APPLICANT [_] NON-APPLICANT SPOUSEIOTHER (] cuarantor
WANE (Last- First Inlet) ER NAME (Last Firet- italy MEMBER NUMBER
FLATOW, KEVIN J
SOCIAL SECURITY NUMBER MOTHER'S MAIDEN NAME BOGIAL SECURITY NUMBER MOTHER'S MAIDEN NAME
E4/AILADDRESS: CELL NUMGER
BIRTH DATE: HOME PHONE BUSINESS PHONE/EXT. BIRTH DATE HOME PRONE BUSINESS PHONEZEXT.
as
PRESENT ADDRESS (Sveat
- City - State - Zip} Clow [rent PRESENT ADDRESS (Steet - Caty- State - Zip) Olown [Jrent
11550 SW 26TH ST #4-110
HOW LONG AT HOUSING HOW LONG AT HOUSING
MIRAMAR, FL 33025 ADDRESS? “4 4M/$ 0.00 ADDRESS? $
PLEASE COMPLETE ONLY IF YOU ARE APPLYING FOR JOINT CREDIT, SECURED CRED, OR IF PLEASE COMPLETE ONLYIF YOU ARE APPLYING
FOR JOINT CREDIT, SECURED CREDITOR IF
‘YOU LIVE INACOMMUNITY FROPERTY STATE. YOU LIVE IN ACOMMUNITY PROPERTY ST
Omarriea ()seraraten [D1 unmarrten (Single - piverced - widowed) Lwaraicn [separate [1 usmarricd (Single - Divorced - Wisowed)
EMPLOYMENT
NAME
AND ADDRESS OF EMPLOYER NAME AND ADDRESS OF EMPLOYER
TESLA MOTORS & 1949 TIGERTAIL BLVD,
DANIA, FL 33004
HOW LONG EMPLOYED POSITION HOW LONG EMPLOYED POSITION
&3 Months VEHICLE PREP SSPECIALLIST
INCOME
OTHER INCOME NOTICE: Ailmony, child support, or separate maintenance OTHER INCOME NOTICE: Alimony, child support, or separate maintenance
income need not be revealed If you do not choose to have it considered. income need not be ravealed if you do not choose to have it considered,
ANNUAL INCOME (GROSS) "ANNUAL INCOME (GROSS)
$48,000.00 $
REFERENCES
"AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU HOME NUMBER NAME AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU. HOME NUMBER
REMESH FOXY
RELATIONSHIP RELATIONSHIP
BEST FRIEND FA
9013 LASER FPDF FI11215 Rev 4.2018 pago
1 of 2 COPYRIGHT 2095 Securian Financial Group, Ine. Ad ripits reserved,
STATENOTICES
OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that
credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with
this law,
WISCONSIN RESIDENTS ONLY: Marital Status: [] Married [unmarried — [] Legally Separated
If married: the name of my spouse is
Spouse's SSN: Spouse's Address (if different)
Notice: No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely
affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms,
before the credit is granted or the account is opened.
MARRIED WISCONSIN RESIDENTS APPLYING FOR AN INDIVIDUAL ACCOUNT: In accordance with Wisconsin Statutes section 766.55(1) by signing
here, | state that the credit being applied for, if granted, will be incurred in the interest of the marriage or family of the Borrower(s),
x
SECURITY INTEREST - The following applies to Credit Card Applicants only
ITI [DITION CREDIT UNDI ICATI
IF YOUR APPLICATION IS APPROVED, YOU SPECIFICALLY GRANT US A CONSENSUAL SECURITY INTEREST IN ALL [INDIVIDUAL AND JOINT
ACCOUNTS YOU HAVE WITH US NOW AND IN THE FUTURE TO SECURE REPAYMENT OF CREDIT EXTENDED UNDER THIS AGREEMENT. YOU
ALSO AGREE THAT WE HAVE SIMILAR STATUTORYLIEN RIGHTS UNDER STATE AND/OR FEDERAL LAW.iF YOU ARE IN DEFAULT, WE CAN
APPLY YOUR SHARES TO THE AMOUNT YOU OWE.
‘Shares and deposits in an Individual Retirement Account or any other account that would lose special tax treatment under state or federal law if given are
not subject to this security interest.
If you have other loans with us, collateral securing such loans will also secure your obligations under this Agreement, unless that other collateral is your
principal residence or non-purchase money household goods.
(Applicant Initials) (Co-Applicant Initials)
LOAN APPLICATION SIGNATURES - PLEASE READ BEFORE SIGNING:
Alt the information in this application is true. | understand that section 1014 Title 18 U.S. Code makes it a federal crime to knowingly make a false statement on
this application. You have my permission to check it. You may retain this application even if not approved. | understand that you may receive information from
others about my credit and you may answer questions and requests from others seeking credit or experience Information about me or my accounts with you. If
this application is approved, | agree to honor the provisions of tho credit or loan agreement and security agreement or credit card agreement covering my
account or loan. (If this application is for two of us, this statement applies to both of us.)
Consumer and Credit Report Authorization. By signing this Application, { authorize you to obtain my consumer and/or credit report for the purposes of
evaluating this application and to obtain subsequent credit reports on an on-going basis in connection with this transaction, and for all other legitimate purposes,
‘such as reviewing my accounts. | authorize you to receive and review other information about me, such as my employment and income information, from third-
parties or consumer reporting agencies.
Vermont Residents: Applicant provided consent via phone (Credit Union Initials)
IMPORTANT NOTICE ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT
To help the government fight the funding of terrorism and money laundering activities, Fedoral law requires all financial institutions to obtain, verify, and record
information that identifies each person who opens an account. What this means for me: When | open an account, you will ask for my name, address, date of
birth, and other information that will allow you to identify me. You may also ask to see my driver's license or other identifying information,
| SIGNATURE
OF APPLICANT DATE SIGNATURE OF GO-APPLICANT DATE
x x
HAVE YOU OMITTED ANYTHING? REMEMBER: INCOMPLETE APPLICATIONS CANNOT BE PROCESSED.
page 2 of 2
‘e TROPICAL Tropical Financial Credit Union CONSUMER LENDING PLAN
FINANCIAL
P.O. Box 829517 ADVANCE RECEIPT AND
Pembroke Pines, FL. 33082-9917 TRUTH-IN-LENDING STATEMENT
iil {From Miami-Dade)
{From all other areas)
BORROWERS NAME “ACCOUNT NUMBER
KEVIN JAY FLATOW
COBORROWER'S NAME DATE
11/26/2018
Thank you for taking a loan advance under your Iending plan. This Advance Receipt and Truth-in-Lending Statement provides important
information regarding the terms of this loan. This advance Is governed by the terms of your Consumer Lending Plan, Open-and Credit Plan,
of similar credit contract ("Plan").
IF YOU BELIEVE THAT ANY OF THIS INFORMATION IS INACCURATE, PLEASE CONTACT US IMMEDIATELY.By accepting the proceeds
of this loan, you are agreeing to the terms stated below.
ANNUAL PERCENTAGE FINANCE CHARGE: The dollar Amount Financed: The amount Total of Payments: The amount
RATE: The cost of your credit as a amount the credit will cost you, of credit provided to you or on you will have paid after you have
yearly rate. your behalf. made all payments as scheduled.
10.400 % $ 8,986.83 $ 25,386.55 $ 34,373.38
—
‘Your payment schedule will ba:
NUMBER OF PAYMENTS AMOUNT OF PAYMENTS WHEN PAYMENTSARE DUE
7t $ 477.42 MONTHLY BEGINNING ON 1/10/2019.
1 $ 476.56 ENDING ON 12/10/2024
Security: You are giving a security interest in your shares and deposits in the crecit union, as well as the collateral described below. Collateral for other
loans with us will also secure this foan, except for your home and household goods.
Late Charges: If a payment Is received more than 10 days after the due date, you will be Required Deposit Balance: The Annual Percentage Rate
charged 5% of each payment due with a minimum cf $20.00 and a maximum of $50.00. does not take into account your required deposit balance.
Property Insurance: You may obtain property insurance from anyone you want that Is accoptable to us. If you do Filing Fee:
not obtain property insurarice we will obtain it at your cost. $0.00
Prepayment: If you pay off early, you will not have to pay a penalty. See your contract documants for any additional Information about nonpayment,
default, any required repayment in full before the scheduled date, and prepayment
| means ostimate, refunds and penalties.
— |
MOUNT SINANCED OF § 25,386.55 Amount Paid to Others an Your Behalf (Describe)
AMOUNT GIVEN TO YOUDIRECTLY § 0.00 GAP {a portion will be CARFAX DOC STAMPS ROUTE 66
retained by us)
$ 610.00 $ 12.00 $ 88.90 $ 2,197.88
AMOUNT PAIDON YOURACCOUNT § 0.00
FLORIDA FINE CARS
PREPAID FINANCE CHARGE $0.00 $ 22,557.77 $
SECURITY INFORMATION
SHARES ‘ACCOUNT NUMBER "AMOUNT ‘ACCOUNT NUMBER, “AMOUNT
PLEDGED: $ §
MOTOR YEAR MAKE MODEL BODY TYPE ‘SERIAL NUMDER or VIN
VEHICLE: 2015 INFINIT] Q50 SEDAN 4D PREMIUM AV] JN1BV7AR2FM394301
OTHER
COLLATERAL:
Credit Insurance: Thank you for purchasing optional credit insurance on your Consumer Lending Plan. The Total Estimated Premium for this
loan is $0.00 , and is included in the payment schedule disclosed above, We will retain a portion of this amount.
Security Interest. When you signed your Lending Plan, you granted a security interest in the above-described collateral, and your
endorsement of the proceeds check and/or your acceptance of the goods purchased and funds advanced now confirm your intent to grant
that security interest. The Security Agreement that you entered into when you opened your Plan shall govern the above-described collateral
and security interest.
SECURITY OFFERED CONSUMER'S CLAIMS AND DEFENSES NOTICE - IF CHECKED, SEE NOTICE BELOW
CONSUMER'S CLAIMS AND DEFENSES NOTICE
The following paragraph appiles only when the box above Is checked.
NOTICE: ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS AND DEFENSES WHICH THE DEBTOR COULD
ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED PURSUANT HERETO OR WITH THE PROCEEDS HEREOF. RECOVERY
HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR HEREUNDER.
9002 LASER MLFPDF F111216 Rev 7-2011 COPYRIGHT 2009 Securian Financial Group, Ine. All ights reserved.
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Case Number: CACE-19-021597 Division: 08 Filing # 97493368 E-Filed 10/18/2019 09:45:14 AM IN THE CIRCUIT COURT OF THE 17TH JUDICIAL CIRCUIT IN AND FOR BROWARD COUNTY, FLORIDA TROPICAL FINANCIAL CREDIT UNION CASE NO.: Plaintiff, CIVIL DIVISION vs. KEVIN JAY FLATOW Defendant. / COMPLAINT The Plaintiff sues the Defendant and alleges the following: 1 This is an action for replevin and money damages which is within this Court's jurisdiction. 2. Plaintiff is a Federal Credit Union. 3 The Defendant is a resident of BROWARD County, Florida, or the Defendant signed the agreements that are the subject matter of this action while residing in BROWARD County, Florida. 4 All conditions precedent have been performed or have been otherwise waived. 5 On November 26, 2018, the Defendant executed and delivered a security agreement (the “Contract”) to the Plaintiff, or its predecessor, securing the purchase of a 2015 INFINITI Q50 (the “Vehicle”). 6. Plaintiff is the owner and holder of the Contract which is attached to this complaint as Exhibit “A.” 7 The Defendant has failed to pay the full payment due on February 10, 2019 and each installment thereafter, and Plaintiff has elected to accelerate payments due under the Promissory Note. IMPORTANT NOTICE TO CONSUMER DEBTORS THIS LAW FIRM MAY BE DEEMED A DEBT COLLECTOR UNDER THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT. THIS IS AN ATTEMPT TO COLLECT A DEBT, ANY INFORMATION PROVIDED WILL BE USED FOR THAT PURPOSE. #** FILED: BROWARD COUNTY, FL BRENDA D. FORMAN, CLERK 10/18/2019 09:45:11 AM.*###* 8 There remains a balance due under the Contract in the amount of $25,386.55, with interest since January 10, 2019. COUNTY I - REPLEVIN 9 Plaintiff re-alleges paragraphs 1 through 8 incorporated herein by reference. 10. This is an action to recover possession of personal property, the Vehicle. 11. To Plaintiff's best knowledge, information and belief, the value of the Vehicle is $13,700.00 and is located at 11550 SW 26TH STREET, APT #4-110, MIRAMAR, FL 33025. 12. Plaintiff is entitled to possession of the Vehicle by virtue of the Contract. See Exhibit “A.” 13. The Vehicle is wrongfully detained by the Defendant who entered into the Contract with Plaintiff in order to obtain possession of the Vehicle. 14. The Defendant came into possession of the Vehicle by purchase through a dealer. 15. The Vehicle has not been taken for any tax, assessment or fine pursuant to law, nor has it been taken under an execution or attachment against Plaintiff’s property, or if so taken, that it is by law exempt from such taking by the following reference to the exemption law relied upon. WHEREFORE, Plaintiff demands final judgment of possession and damages against the Defendant, including interest and any costs authorized by law. COUNT Il —- CONVERSION 16. Plaintiff re-alleges paragraphs 1 through 8 incorporated herein by reference. 17. Defendant converted to Defendant’s own use the Vehicle which is pledged as security to Plaintiff pursuant to the Contract. WHEREFORE, Plaintiff demands judgment for damages against the Defendant in favor of Plaintiff. IMPORTANT NOTICE TO CONSUMER DEBTORS THIS LAW FIRM MAY BE DEEMED A DEBT COLLECTOR UNDER THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT. THIS IS AN ATTEMPT TO COLLECT A DEBT, ANY INFORMATION PROVIDED WILL BE USED FOR THAT PURPOSE. COUNT Ill —- BREACH OF CONTRACT 18. Plaintiff re-alleges paragraphs 1 through 8 incorporated herein by reference. 19. The Defendant breached the Contract by failing to pay the full payment due on February 10, 2019. 20. There remains a balance due under the Contract in the amount of $25,386.55, with interest since January 10, 2019. 21. Pursuant to the terms of the Contract, the Defendant is obligated to pay attorney's fees and costs and that the Plaintiff is obligated to pay its attorney a reasonable fee. WHEREFORE, Plaintiff demands the following: A Judgment for damages against the Defendant in favor of the Plaintiff in the amount of $25,386.55; B Award of costs of collection and reasonable attorney's fees, late charges and interest pursuant to the Contract; and C Any other further relief as the Court may deem fit. Dunn Law, P.A. Counsel for Plaintiff 66 West Flagler Street, Suite 400 Miami, Florida 33130 Phone: (786) 433-3866 Fax: (786) 260-0269 joshua.kligler@dunnlawpa.com By: /s| Geahua C Kigler Joshua C. Kligler, Esq. Fla. Bar No. 69397 IMPORTANT NOTICE TO CONSUMER DEBTORS THIS LAW FIRM MAY BE DEEMED A DEBT COLLECTOR UNDER THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT. THIS IS AN ATTEMPT TO COLLECT A DEBT, ANY INFORMATION PROVIDED WILL BE USED FOR THAT PURPOSE. SIE Tropical Financial Credit Union LOAN APPLICATION P.O. Box 829517 - Pembroke Pines, Florida 33082-9917 (888) 261-8328 FAX: (954) 499-6748 tarried Applicants may apply for a separate account. Check the appropriate box to indicate Individual Credit or Joint Credit. individual Credit: Complete Applicant sections if only the applicant's income is considered for loan approval. Complete Applicant and Co-Applicant sections: (1) if you are relying on income from alimony, child support, or separate maintenance ‘or on the Income or assets of another person as the basis for repayment of credit requested; (2) If you reside In a Community Property State; (3) if you are rolying on property loceted in a Community Property State as a basis for rapayment of the credit requested; or (4) if you are an Alaska resident subject to a community property agreement or community property trust. Community Property States include: AZ, CA, ID, LA, NM, NV, TX, WA, Wi. CD vont Greait: Complete Applicant and Co-Applicant sections if your co-applicant will be contractually liable for repayment of the loan and Initial below: We intend to apply for joint credit. (Applicant initials) (Co-Applicant Initials) PLEASE CHECK BELOW TO INDICATE THE TYPE OF ACCOUNT(S) AND TYPE OF CREDIT FOR WHICH YOU ARE APPLYING. Ei] Auto [Personal Line of Credit [1] Savings Secured Credit Line Credit Cards: [] Mastercard® Platinum [[] Mastercard® Platinum Secured Ci Mastercad® Platinum Rewards Certificate Secured [] Recreational Vehicle CD Other Loan Request. OMastercard® Platinum Elke Account/Loan: [individual T)Joint Account: CD) Individual Dvoint (including ATid/Debh Card Access to the Account if Available) Number of cards requested: Amount Requested $ 27,000.00 [1 Authorized User Requested (Separate form to be provided) Purpose/Collateral:; PURCHASE SEE SEPARATE IMPORTANT CREDIT CARD DISCLOSURE APPLICANT |[] CO-APPLICANT [_] NON-APPLICANT SPOUSEIOTHER (] cuarantor WANE (Last- First Inlet) ER NAME (Last Firet- italy MEMBER NUMBER FLATOW, KEVIN J SOCIAL SECURITY NUMBER MOTHER'S MAIDEN NAME BOGIAL SECURITY NUMBER MOTHER'S MAIDEN NAME E4/AILADDRESS: CELL NUMGER BIRTH DATE: HOME PHONE BUSINESS PHONE/EXT. BIRTH DATE HOME PRONE BUSINESS PHONEZEXT. as PRESENT ADDRESS (Sveat - City - State - Zip} Clow [rent PRESENT ADDRESS (Steet - Caty- State - Zip) Olown [Jrent 11550 SW 26TH ST #4-110 HOW LONG AT HOUSING HOW LONG AT HOUSING MIRAMAR, FL 33025 ADDRESS? “4 4M/$ 0.00 ADDRESS? $ PLEASE COMPLETE ONLY IF YOU ARE APPLYING FOR JOINT CREDIT, SECURED CRED, OR IF PLEASE COMPLETE ONLYIF YOU ARE APPLYING FOR JOINT CREDIT, SECURED CREDITOR IF ‘YOU LIVE INACOMMUNITY FROPERTY STATE. YOU LIVE IN ACOMMUNITY PROPERTY ST Omarriea ()seraraten [D1 unmarrten (Single - piverced - widowed) Lwaraicn [separate [1 usmarricd (Single - Divorced - Wisowed) EMPLOYMENT NAME AND ADDRESS OF EMPLOYER NAME AND ADDRESS OF EMPLOYER TESLA MOTORS & 1949 TIGERTAIL BLVD, DANIA, FL 33004 HOW LONG EMPLOYED POSITION HOW LONG EMPLOYED POSITION &3 Months VEHICLE PREP SSPECIALLIST INCOME OTHER INCOME NOTICE: Ailmony, child support, or separate maintenance OTHER INCOME NOTICE: Alimony, child support, or separate maintenance income need not be revealed If you do not choose to have it considered. income need not be ravealed if you do not choose to have it considered, ANNUAL INCOME (GROSS) "ANNUAL INCOME (GROSS) $48,000.00 $ REFERENCES "AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU HOME NUMBER NAME AND ADDRESS OF NEAREST RELATIVE NOT LIVING WITH YOU. HOME NUMBER REMESH FOXY RELATIONSHIP RELATIONSHIP BEST FRIEND FA 9013 LASER FPDF FI11215 Rev 4.2018 pago 1 of 2 COPYRIGHT 2095 Securian Financial Group, Ine. Ad ripits reserved, STATENOTICES OHIO RESIDENTS ONLY: The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law, WISCONSIN RESIDENTS ONLY: Marital Status: [] Married [unmarried — [] Legally Separated If married: the name of my spouse is Spouse's SSN: Spouse's Address (if different) Notice: No provision of any marital property agreement, unilateral statement under Section 766.59, or court decree under Section 766.70 will adversely affect the rights of the Credit Union unless the Credit Union is furnished a copy of the agreement, statement or decree, or has actual knowledge of its terms, before the credit is granted or the account is opened. MARRIED WISCONSIN RESIDENTS APPLYING FOR AN INDIVIDUAL ACCOUNT: In accordance with Wisconsin Statutes section 766.55(1) by signing here, | state that the credit being applied for, if granted, will be incurred in the interest of the marriage or family of the Borrower(s), x SECURITY INTEREST - The following applies to Credit Card Applicants only ITI [DITION CREDIT UNDI ICATI IF YOUR APPLICATION IS APPROVED, YOU SPECIFICALLY GRANT US A CONSENSUAL SECURITY INTEREST IN ALL [INDIVIDUAL AND JOINT ACCOUNTS YOU HAVE WITH US NOW AND IN THE FUTURE TO SECURE REPAYMENT OF CREDIT EXTENDED UNDER THIS AGREEMENT. YOU ALSO AGREE THAT WE HAVE SIMILAR STATUTORYLIEN RIGHTS UNDER STATE AND/OR FEDERAL LAW.iF YOU ARE IN DEFAULT, WE CAN APPLY YOUR SHARES TO THE AMOUNT YOU OWE. ‘Shares and deposits in an Individual Retirement Account or any other account that would lose special tax treatment under state or federal law if given are not subject to this security interest. If you have other loans with us, collateral securing such loans will also secure your obligations under this Agreement, unless that other collateral is your principal residence or non-purchase money household goods. (Applicant Initials) (Co-Applicant Initials) LOAN APPLICATION SIGNATURES - PLEASE READ BEFORE SIGNING: Alt the information in this application is true. | understand that section 1014 Title 18 U.S. Code makes it a federal crime to knowingly make a false statement on this application. You have my permission to check it. You may retain this application even if not approved. | understand that you may receive information from others about my credit and you may answer questions and requests from others seeking credit or experience Information about me or my accounts with you. If this application is approved, | agree to honor the provisions of tho credit or loan agreement and security agreement or credit card agreement covering my account or loan. (If this application is for two of us, this statement applies to both of us.) Consumer and Credit Report Authorization. By signing this Application, { authorize you to obtain my consumer and/or credit report for the purposes of evaluating this application and to obtain subsequent credit reports on an on-going basis in connection with this transaction, and for all other legitimate purposes, ‘such as reviewing my accounts. | authorize you to receive and review other information about me, such as my employment and income information, from third- parties or consumer reporting agencies. Vermont Residents: Applicant provided consent via phone (Credit Union Initials) IMPORTANT NOTICE ABOUT PROCEDURES FOR OPENING A NEW ACCOUNT To help the government fight the funding of terrorism and money laundering activities, Fedoral law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for me: When | open an account, you will ask for my name, address, date of birth, and other information that will allow you to identify me. You may also ask to see my driver's license or other identifying information, | SIGNATURE OF APPLICANT DATE SIGNATURE OF GO-APPLICANT DATE x x HAVE YOU OMITTED ANYTHING? REMEMBER: INCOMPLETE APPLICATIONS CANNOT BE PROCESSED. page 2 of 2 ‘e TROPICAL Tropical Financial Credit Union CONSUMER LENDING PLAN FINANCIAL P.O. Box 829517 ADVANCE RECEIPT AND Pembroke Pines, FL. 33082-9917 TRUTH-IN-LENDING STATEMENT iil {From Miami-Dade) {From all other areas) BORROWERS NAME “ACCOUNT NUMBER KEVIN JAY FLATOW COBORROWER'S NAME DATE 11/26/2018 Thank you for taking a loan advance under your Iending plan. This Advance Receipt and Truth-in-Lending Statement provides important information regarding the terms of this loan. This advance Is governed by the terms of your Consumer Lending Plan, Open-and Credit Plan, of similar credit contract ("Plan"). IF YOU BELIEVE THAT ANY OF THIS INFORMATION IS INACCURATE, PLEASE CONTACT US IMMEDIATELY.By accepting the proceeds of this loan, you are agreeing to the terms stated below. ANNUAL PERCENTAGE FINANCE CHARGE: The dollar Amount Financed: The amount Total of Payments: The amount RATE: The cost of your credit as a amount the credit will cost you, of credit provided to you or on you will have paid after you have yearly rate. your behalf. made all payments as scheduled. 10.400 % $ 8,986.83 $ 25,386.55 $ 34,373.38 — ‘Your payment schedule will ba: NUMBER OF PAYMENTS AMOUNT OF PAYMENTS WHEN PAYMENTSARE DUE 7t $ 477.42 MONTHLY BEGINNING ON 1/10/2019. 1 $ 476.56 ENDING ON 12/10/2024 Security: You are giving a security interest in your shares and deposits in the crecit union, as well as the collateral described below. Collateral for other loans with us will also secure this foan, except for your home and household goods. Late Charges: If a payment Is received more than 10 days after the due date, you will be Required Deposit Balance: The Annual Percentage Rate charged 5% of each payment due with a minimum cf $20.00 and a maximum of $50.00. does not take into account your required deposit balance. Property Insurance: You may obtain property insurance from anyone you want that Is accoptable to us. If you do Filing Fee: not obtain property insurarice we will obtain it at your cost. $0.00 Prepayment: If you pay off early, you will not have to pay a penalty. See your contract documants for any additional Information about nonpayment, default, any required repayment in full before the scheduled date, and prepayment | means ostimate, refunds and penalties. — | MOUNT SINANCED OF § 25,386.55 Amount Paid to Others an Your Behalf (Describe) AMOUNT GIVEN TO YOUDIRECTLY § 0.00 GAP {a portion will be CARFAX DOC STAMPS ROUTE 66 retained by us) $ 610.00 $ 12.00 $ 88.90 $ 2,197.88 AMOUNT PAIDON YOURACCOUNT § 0.00 FLORIDA FINE CARS PREPAID FINANCE CHARGE $0.00 $ 22,557.77 $ SECURITY INFORMATION SHARES ‘ACCOUNT NUMBER "AMOUNT ‘ACCOUNT NUMBER, “AMOUNT PLEDGED: $ § MOTOR YEAR MAKE MODEL BODY TYPE ‘SERIAL NUMDER or VIN VEHICLE: 2015 INFINIT] Q50 SEDAN 4D PREMIUM AV] JN1BV7AR2FM394301 OTHER COLLATERAL: Credit Insurance: Thank you for purchasing optional credit insurance on your Consumer Lending Plan. The Total Estimated Premium for this loan is $0.00 , and is included in the payment schedule disclosed above, We will retain a portion of this amount. Security Interest. When you signed your Lending Plan, you granted a security interest in the above-described collateral, and your endorsement of the proceeds check and/or your acceptance of the goods purchased and funds advanced now confirm your intent to grant that security interest. The Security Agreement that you entered into when you opened your Plan shall govern the above-described collateral and security interest. SECURITY OFFERED CONSUMER'S CLAIMS AND DEFENSES NOTICE - IF CHECKED, SEE NOTICE BELOW CONSUMER'S CLAIMS AND DEFENSES NOTICE The following paragraph appiles only when the box above Is checked. NOTICE: ANY HOLDER OF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS AND DEFENSES WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED PURSUANT HERETO OR WITH THE PROCEEDS HEREOF. RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR HEREUNDER. 9002 LASER MLFPDF F111216 Rev 7-2011 COPYRIGHT 2009 Securian Financial Group, Ine. All ights reserved.