GUARANTEED ASSET PROTECTION (GAP)
Entered into by and between the retail buyer (consumer, You, or Your) and the retail seller or holder.
CONSUMER RETAIL SELLER ACCOUNT NUMBER
CITY STATE ZIP CITY STATE ZIP
HOME PHONE BUSINESS PHONE PHONE CONTACT
YEAR MAKE MODEL VIN CURRENT MILEAGE RETAIL AMOUNT FINANCED
VALUE TO RETAIL VALUE
RETAIL INSTALLMENT CONTRACT VEHICLE PURCHASE PRICE HOLDER
J COMMERCIAL USE TERM OF THE RETAIL INSTALLMENT CONTRACT IN ADDRESS
J ONE TON TRUCK/VAN MONTHS
J NEW J USED AMOUNT FINANCED CITY STATE ZIP
GUARANTEED ASSET PROTECTION WAIVER COST ANNUAL PERCENTAGE RATE PHONE CONTACT
AGREEMENT - This Waiver is a part of, and is incorporated into, Your Retail Installment Contract. In the event of a Total Loss of the Motor Vehicle, the amount of debt
waived shall be the Deficiency between the Outstanding Balance as of the Date of Loss and the Actual Cash Value, subject to the terms, conditions, limitations, and
exclusions in this Waiver. The Deficiency shall not exceed $50,000 in total. You will remain responsible for the payment of all Primary Insurance deductibles over $1,000
and any Amounts Not Covered under this Waiver.
This Waiver expires upon the earliest of (1) the original termination date of the Retail Installment Contract; (2) the early termination (including refinance) of the Retail
Installment Contract; (3) 84 months from the Retail Installment Contract date; or (4) the Waiver term disclosed on this page. No Motor Vehicle with a Retail Value greater
than $100,000 as of the date of this Waiver is covered hereunder; if a Total Loss is excluded because of this Retail Value limit, then You/Holder will receive a full refund
of the cost of this Waiver.
CANCELLATION - YOU MAY CANCEL THIS WAIVER ANY TIME PRIOR TO A TOTAL LOSS BY MAILING OR DELIVERING A WRITTEN CANCELLATION REQUEST TO THE
RETAIL SELLER, HOLDER OR PROGRAM ADMINISTRATOR. IF A CANCELLATION IS REQUESTED WITHIN 30 DAYS OF THE DATE OF THE WAIVER, YOU WILL RECEIVE
A FULL REFUND. A CANCELLATION REQUEST RECEIVED AFTER 30 DAYS OF THE DATE OF THE WAIVER WILL BE REFUNDED BY RULE OF 78 METHOD (PRO-RATA
METHOD FOR ALLY, CHASE AND FMCC) LESS A $50 CANCELLATION FEE (NO CANCELLATION FEE FOR FMCC). THE HOLDER WILL BE NAMED AS SOLE PAYEE ON
ANY REFUND UNLESS YOU CAN SHOW THAT THE RETAIL INSTALLMENT CONTRACT HAS BEEN PAID IN FULL. THIS WAIVER WILL NOT BE REINSTATED AFTER A
CANCELLATION IS REQUESTED. THE REFUND SHALL BE BASED UPON THE EARLIEST OF: (1) THE PREPAYMENT OF THE RETAIL INSTALLMENT CONTRACT IN FULL
BEFORE THE ORIGINAL MATURITY DATE; (2) A DEMAND BY THE HOLDER FOR PAYMENT IN FULL OF THE UNPAID BALANCE OR ACCELERATION; (3) YOUR REQUEST
FOR CANCELLATION; OR (4) THE TOTAL DENIAL OF A REQUEST FOR BENEFITS BASED UPON AN EXCLUSION. A REFUND IS NOT REQUIRED IF THE AMOUNT OF THE
REFUND IS LESS THAN $5.
MANDATORY DISCLOSURES, ACKNOWLEDGEMENT, AND ACCEPTANCE
PURCHASE OF THIS WAIVER IS OPTIONAL. THIS WAIVER IS NOT NECESSARY FOR THE EXTENSION OF CREDIT, TERMS OF CREDIT, OR TERMS OF THE RETAIL
INSTALLMENT CONTRACT AND THE TERMS OF THE RELATED MOTOR VEHICLE SALE. WE WILL CANCEL CERTAIN AMOUNTS YOU OWE UNDER THIS WAIVER IN THE
CASE OF A TOTAL LOSS OF THE COVERED VEHICLE AS STATED IN THIS WAIVER.
YOU MAY CANCEL THIS WAIVER AT ANY TIME PRIOR TO A TOTAL LOSS AND RECEIVE A REFUND. ELIGIBILITY REQUIREMENTS, CONDITIONS, AND EXCLUSIONS COULD
PREVENT YOU FROM RECEIVING BENEFITS. YOU SHOULD CAREFULLY READ THIS WAIVER FOR A FULL EXPLANATION OF THE PROTECTION PROVIDED.
THIS WAIVER IS NOT INSURANCE AND IS NOT A SUBSTITUTE FOR AND DOES NOT PROVIDE BODILY INJURY, PROPERTY DAMAGE, LIABILITY, OR COLLISION
INSURANCE AND DOES NOT COMPLY WITH ANY FINANCIAL RESPONSIBILITY LAW OR ANY OTHER LAW MANDATING MOTOR VEHICLE INSURANCE COVERAGE.
YOU ARE RESPONSIBLE FOR MAINTAINING COLLISION AND COMPREHENSIVE INSURANCE ON THE MOTOR VEHICLE.
I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND ALL OF THE PROVISIONS OF THIS WAIVER AND THAT THE INFORMATION SHOWN ABOVE IS, TO THE BEST OF MY
KNOWLEDGE, TRUE AND IDENTICAL TO THE RETAIL INSTALLMENT CONTRACT. NO STATEMENTS HAVE BEEN MADE TO ME THAT DIFFER FROM THIS WAIVER. I ACCEPT
ALL OF THE DISCLOSURES.
COST TERM OF THIS WAIVER I ACCEPT THIS GUARANTEED
$ WAIVER X
Consumer Signature(s) Date
Retail Seller Signature Title Date
Program Administrator – 1785 Hancock Street, Suite 100 • San Diego, CA 92110-2051 • Telephone (619) 228-0100 • Fax (619) 228-0129
ADMINISTRATOR – WHITE HOLDER – YELLOW DEALER – PINK CONSUMER – WHITE TX.AFA.SB.LZX84145 (1111)
MOTOR VEHICLE TYPE
AUTO, VAN, LIGHT TRUCK/SUV – Includes four-wheeled private passenger automobiles, vans, light trucks, or SUVs that are described in the Retail
ONE TON TRUCK or VAN – Coverage is limited to the following trucks and vans: Chevrolet 3500 Series and Chevrolet Express, Ford E350, F350 and
F450, Dodge 3500 Series, Dodge 3500 Ram Vans and Dodge 3500 Sprinter, GMC 3500 Series and GMC Savana. This Waiver does not apply to any
other one ton truck or van.
CATEGORY LIMITATION – All Motor Vehicles must be utilized for personal purposes, and be less than 12,500 pounds gross vehicle weight rating
(GVWR), and can not have a Retail Value greater than $100,000 at the date of this Waiver.
If a Total Loss is excluded under either the ONE TON TRUCK or VAN or the CATEGORY LIMITATION provision above, then You and/or the Holder will
receive a full refund of the cost of this Waiver.
COMMERCIAL USE – A Deficiency is not covered for a Total Loss unless the Commercial Use Option is disclosed/purchased. Commercial Use
means a vehicle that is not used primarily for personal, family or household use; is owned by a corporation, limited liability company, limited
partnership, or other business entity; or is part of a fleet of 5 or more vehicles owned by You. (Commercial Use is not available for FMCC.)
LIMITATIONS AND TERMS
Deferred Payment Financing – The amount by which the Amount Financed exceeds 125% of the Retail Value will be subtracted from the
Amounts Not Covered – The Deficiency shall not include any of the following: (1) any proceeds that could be recovered from canceling items such
as, but not limited to, a service contract, credit insurance, unpaid insurance premiums and similar items in the Retail Installment Contract;
(2) amounts added to the Retail Installment Contract after the retail sale of the Motor Vehicle, Delinquent Installments, delinquency charge and
Deferred Installments; (3) prior unrepaired damage, salvage, deductible recoverable from the at fault insurance carrier, towing, storage, applicable
taxes and fees; (4) any unpaid parking tickets, tolls or other violations for which the Holder is charged; (5) trailers, specialized optional equipment,
accessories or body components; (6) accident tax, crash tax or any other fine or fee imposed by any governmental or quasi-governmental authority
for responding to an accident.
Excess – This Waiver is excess over any valid and collectible insurance. This means all insurance, which covers the Motor Vehicle or You. Only
when all such insurance is exhausted shall this Waiver apply.
Assignment – This Waiver remains a part of the Retail Installment Contract upon the assignment, sale or transfer of the Retail Installment Contract
by the Holder. With the written consent of the Holder, You may transfer Your equity in the Motor Vehicle subject to the Retail Installment Contract
to another person and this Waiver shall remain in effect.
Total Loss – In the event of a Total Loss, You must keep Your account current until the Deficiency is settled. Request for a Deficiency determination
must be submitted within 90 days from Primary Insurance settlement check date or if there is no Primary Insurance as of the Date of Loss, 90
days from the Date of Loss. Any request for a Deficiency submitted after the 90 day period is void.
You shall provide the following documentation to the Program Administrator: (1) Complete a debt cancellation request form; (2) a copy of the
Primary Insurance settlement check(s) and settlement valuation and worksheet; (3) a copy of the police report made for the incident (FMCC-if the
Motor Vehicle was stolen); (4) a copy of the original Retail Installment Contract and all addenda, including the Motor Vehicle valuation
documentation identifying model type and options at the time of retail sale, bill of sale if provided to You, and proof of proceeds recovered from
cancellation of refundable items, such as a service contract, credit insurance, or other similar items; (5) a complete payment history; (6) a copy of
All copies must be complete and legible. You agree to cooperate with the Program Administrator in the verification of any information submitted.
You will not be required to provide additional documentation that is not listed in this Waiver to substantiate the loss or determine the amount of
debt to be cancelled. On reasonable advance notice, the Retail Seller, Holder or Program Administrator may inspect Your Motor Vehicle.
No Waiver of debt will occur for a Total Loss due to: (1) any dishonest, fraudulent, illegal, or intentional act of any authorized driver that directly
results in the Total Loss of the Motor Vehicle; (2) any act of gross negligence by an authorized driver that directly results in the Total Loss of the
Motor Vehicle; (3) conversion, embezzlement, or concealment by any person in lawful possession of the Motor Vehicle; (4) lawful confiscation by
an authorized public official; (5) operation, use, or maintenance of the Motor Vehicle in any race or speed contest; (6) war, whether or not declared,
invasion, insurrection, rebellion, revolution, or an act of terrorism (except FMCC); (7) use of the Motor Vehicle for primarily commercial purposes if
the Commercial Use Option is not disclosed/purchased as of the date of this Waiver; (8) damage that occurs after the Motor Vehicle has been
repossessed; (9) damage to the Motor Vehicle before the purchase of this Waiver; (10) any loss occurring outside the Territory; (11) an act occurring
after the original maturity date or date of the Holder ’s acceleration of the Financial Agreement; (12) normal wear and tear, freezing, or mechanical
or electrical breakdown or failure; (13) damage related to any personal property attached to or within the Motor Vehicle; (14) damages associated
with falsification of documents by any person not associated with the Retail Seller or other person canceling Your Deficiency; (15) any unpaid debt
resulting from exclusions in Your Primary Insurance policy not included in this Waiver; (16) abandonment of the Motor Vehicle by You, only if You
voluntarily discard, leave behind, or otherwise relinquish possession of the Motor Vehicle to the extent the relinquishment shows intent to forsake
and desert the Motor Vehicle so that the Motor Vehicle may be appropriated by any other person; (17) any Motor Vehicle that is: a Salvage Motor
Vehicle as of the date of the Retail Installment Contract, or used as an Emergency Vehicle, or Classic or Antique or Special Interest Motor Vehicle, or
Tow Truck Vehicle; (18) if the Actual Cash Value exceeds the Outstanding Balance; (19) if the Motor Vehicle is used for livery, used for hire, rental
or as a taxi. If a Total Loss is excluded under seven (7), seventeen (17) or nineteen (19) above, then You and/or the Holder will receive a full refund
of the cost of this Waiver.
Actual Cash Value means the gross settlement calculated by Your Primary Insurance company less any physical damage deductible up to $1,000.
If there is no Primary Insurance on the Date of Loss, then Actual Cash Value shall mean the Retail Value.
Date of Loss means the date on which the actual physical loss or damage occurred on the Motor Vehicle.
Deferred Installment means a Retail Installment Contract is amended to defer all or part of one or more installments.
Deferred Payment Financing means the first scheduled payment is due 90 days or more after the date of the Retail Installment Contract.
Deficiency means the amount of debt waived, which shall be the difference between the Outstanding Balance as of the Date of Loss and the Actual
Cash Value subject to the limitations, exclusions, terms and conditions in this Waiver.
Delinquent Installment means any installment owed under the original terms of the Retail Installment Contract that as of the Date of Loss remained
unpaid for more than 30 days after the original due date.
Retail Installment Contract means the document(s) which this Waiver amends and becomes a part of, evidencing the retail sale of the Motor Vehicle.
Holder means the creditor of the Retail Installment Contract.
Amount Financed to Retail Value Ratio means the Retail Installment Contract amount financed as a percentage of the Retail Value of the Motor
Motor Vehicle means the Motor Vehicle listed on the first page of this Waiver and meets the Motor Vehicle Type requirements and used within the
Outstanding Balance means the amount in U.S. currency as of the Date of Loss required to pay the Retail Installment Contract balance per the terms
of the Retail Installment Contract as it existed on the Retail Installment Contract date listed on the first page of this Waiver.
Primary Insurance means comprehensive and collision insurance coverage as required by the Retail Installment Contract.
Emergency Vehicle means a motor vehicle used: as a fire department or police vehicle; as a public or private ambulance; by volunteer firefighters
when responding to a fire alarm; an industrial ambulance; as a vehicle of a blood bank or tissue bank when making deliveries of blood, drugs,
medicines or organs; or for law enforcement purposes.
Classic or Antique or Special Interest Motor Vehicle means a motor vehicle that is: at least 25 years old; or used primarily for exhibitions, club
activities, parades and other functions of public interest; or any age but has not been changed from original manufacturer’s specifications and
because of its historic interest is being preserved by a hobbyist.
Tow Truck Vehicle means a motor vehicle adapted or used to tow, winch or otherwise move another motor vehicle.
Retail Value means the Manufacturer’s Suggested Retail Price (MSRP) per National Automobile Dealer Association (NADA) regional guide, for new
Motor Vehicles or NADA Retail Value for used Motor Vehicles, or equivalent market valuation method, including available standard or optional
equipment, factory approved conversion packages and Retail Seller installed options.
Salvage Motor Vehicle means a Motor Vehicle that as of the Retail Installment Contract date is damaged and that comes into Texas under an out-
of-state salvage motor vehicle certificate of title or similar out-of-state ownership document that states on its face “accident damage,” “flood
damage,” “inoperable,” “rebuildable,” “salvageable,” or similar notation; or a motor vehicle for which an insurance company has paid a claim for
the cost of repairing hail damage or theft.
Territory means the United States, its territories or possessions; and Canada.
Total Loss means the Motor Vehicle is deemed a Total Loss by the Primary Insurance company due to an insured peril where the damages to the
Motor Vehicle are greater than or equal to the Retail Value of the Motor Vehicle immediately prior to the Date of Loss. If there is no Primary Insurance
on the Date of Loss, then Total Loss means the damages to the Motor Vehicle are greater than or equal to the Retail Value of the Motor Vehicle
immediately prior to the Date of Loss or the Motor Vehicle is stolen and not recovered within 30 days after the Date of Loss.
Waiver means this Guaranteed Asset Protection Waiver, which amends Your Retail Installment Contract.
You, Your means the consumer(s) listed on the first page of this Waiver.
Complaints: A complaint regarding this Waiver may be submitted to the Office of Consumer Credit Commissioner, 2601 N. Lamar Blvd. #201, Austin,
TX 78705-4207 (800) 538-1579 http://www.occc.state.tx.us.
If any provision of this Waiver conflicts with the laws of the State where it is issued, then the provision(s) is severable and hereby amended to
conform to state law. The remaining provisions of this Waiver remain in full force.
You may direct all inquiries regarding this Waiver to:
1785 Hancock Street, Suite 100 • San Diego, CA 92110-2051 • Phone (619) 228-0100 • Fax (619) 228-0129
BENEFIT INFORMATION GUARANTEED ASSET
— BENEFIT SUMMARY — PROTECTION WAIVER
This Waiver cancels debt if your Motor Vehicle is damaged
beyond repair or is stolen and can not be recovered, and
the proceeds of your insurance or amounts you received
Motor Vehicle is stolen).
from third persons is not sufficient to satisfy what you owe
under your Motor Vehicle Retail Installment Contract.
settlement valuation and worksheet.
1. Complete a Debt Cancellation request form.
— IMPORTANT DISCLOSURES — KEEP THIS WITH YOUR
WAIVER IS OPTIONAL FINANCIAL AGREEMENT
THIS WAIVER IS NOT NECESSARY FOR THE EXTENSION OF
CREDIT, TERMS OF CREDIT, OR TERMS OF THE RETAIL
including the Motor Vehicle valuation documentation identifying
3. A copy of the police report made for the incident (FMCC - if the
2. A copy of the Primary Insurance settlement check(s) and the
4. A copy of the original Retail Installment Contract and all addenda,
INSTALLMENT CONTRACT. Whether or not you purchase this
Waiver will not affect your application for credit or the
terms of any existing credit agreement you have. If you
wish to purchase this Waiver on a purely voluntary basis,
you may do so by reviewing this Waiver and then signing DIRECT ALL INQUIRIES TO
the Mandatory Disclosures, Acknowledgement, and
Acceptance section of this Waiver.
6. A copy of this Waiver.
REQUESTING BENEFITS FOR A TOTAL LOSS
REFUND OF FEE PAID IN LUMP SUM
5. A complete payment history.
You may cancel this Waiver at any time prior to a total loss
insurance or other similar items.
and receive a refund.
AND EXCLUSIONS 1785 Hancock Street, Suite 100
San Diego, CA 92110-2051
You shall provide the following documentation to the Program Administrator. All copies must be complete and legible.
There are requirements, conditions, and exclusions that Telephone: (619) 228-0100
could prevent you from receiving benefits. You should
carefully read this Waiver for a full explanation of the
Fax: (619) 228-0129
cancellation of refundable items, such as a service contract, credit
provided to You, and proof of proceeds recovered from
model, type and options at the time of retail sale, bill of sale if