(a) Be dated and signed by or on behalf of the insured, and the printed portion thereof shall be in at least eight-point type;
(b) Contain the name and place of business of the insurance agent or broker negotiating the related insurance contract, the name and residence or place of business of the insured, the name and place of business of the premium finance company, a brief description of the insurance contracts involved and the amount of the premium; and
(c) Set forth the following items, where applicable:
(i) The total amount of the premium, less an itemized listing of any nonrefundable charges;
(ii) The amount of the down payment;
(iii) The principal balance, which is the difference between the amounts stated under subparagraphs (i) and (ii) of this paragraph;
(iv) The amount of the interest and the annual percentage rate;
(v) The balance payable by the insured, meaning the sum of amounts stated under subparagraphs (iii) and (iv) of this paragraph; and
(vi) The number of installments required, the amount of each installment expressed in dollars and the due date or period thereof.
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