Attention: Please be sure to register the VSC contract in ESPS. If you have used the Ford eForms / eContract system to complete the electronic form for the VSC, it is not necessary to also register the contract in ESPS to complete the activation.

Selling Dealer

PA Code

Dealer Name

City, State and Zip

Vehicle Information

VIN

Current Odometer

Make Model Year

Purchaser Service Contract

First Name

Middle Initial

Last Name

Address 1

Address 2

City

State

Postal Code

Mobile Phone

Home Phone

Work Phone

Financial Contract

	Purchase Price	Sales Tax	Down Payment
Contract #1	$	$	$
Contract #2	$	$	$
Contract #3	$	$	$
Contract #4	$	$	$
Contract #5	$	$	$
Clear Contracts Add Contract

Annual Percentage	Finance Charge	Amount Financed	Total Of Payments	Total Sale Price
% The cost of your credit as a yearly rate.	$ The dollar amount the credit will cost you.	$ The amount of credit provided to you or on your behalf.	$ The amount you will have paid after you have made all payments as scheduled.	$ The total cost of your purchase on credit, including your down payment.
The Ohio law against discrimination requires that all creditors make credit equally available to all credit worthy customers, and that credit reporting agencies maintain separate histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

Payment Information

VSC Coverage Term	Number of Payments	Amount of Payments	Payments Are Due	Payment Method
		$

Routing Number

Account Number

Account Number Confirmation

Bank Name

Bank City

Bank State

Bank Zip

Account Type

SavingsChecking

Preferred Day

First Of Each Month15th of each month

Card Type

Cardholder Name

Card Number

Expiration Date

CCV

Address is Same as Mailing

Billing Address 1

Billing Address 2

Billing City

Billing State

Billing Zip

Invoice Delivery

Email invoice to the email address listed above

Mail invoice by USPS to the address listed above

Please select a pay method

Generate Contract(s)

Purchaser Agreement

To submit the electronically signed contract, please check the boxes for the Purchaser, then click Generate Contract. If the box is not checked, the contract will be submitted electronically without signature. This will require a physically signed copy of the Installment Payment Plan Contract to be submitted to Budco Financial via email, fax or mail.

Clear Fields

Customers can use IPP to buy all VSC new or used plans with 12 or more months of coverage.*

VSC Coverage Terms	Eligible IPP Financing Term
12 months	6 months (only)
24 months	6 or 12 months (only)
36 months	6, 12 or 18 months (only)
48 months or greater	6, 12, 18 or 24 months

*Excluding EtchCARE

eContracting Form

General IPP Guidelines and Eligibility