Tyco Employee Computer Purchase Promissory Note
Please Print This Form and Submit HARD COPY (Original Signatures Are Required)
(Name of Tyco Division)
I, the undersigned, hereby promise to pay to the order of (Name of Tyco Div.)____________________
an operating company of Tyco International Ltd. (the "Company"), at its office at
(Address of Tyco Div.)_____________________________________________________________________________________________
the sum of $ ______________ (the "Loan"), without interest. The amount of the Loan will be paid by the
Company to NECB Data Systems at 65
Aviation Avenue, Portsmouth, NH 03801 for the purchase of
my computer system, through the Tyco Employee Computer Purchase Program.
The Loan shall be paid in the following manner:
- The Company is hereby authorized to deduct per pay period the sum of $___________ for _______ payments (not to exceed 18 months).
- In the event that my employment with the Company is terminated before the Loan is paid in full, I will repay the outstanding balance of the Loan on my termination date.
- I will provide the Company with the detailed receiving slip or paid invoice upon receipt of the above-mentioned system.
- Should it become necessary for the Company to collect any outstanding balance on the Loan, I agree to pay all reasonable attorney fees, collection fees, court costs, and any other expenses incurred in collecting the Loan.
Print Full Name of Employee
Employee's Signature / Date
Employee's Identification Number (In U.S. use Social Security Number)
Computer Purchase Program Coordinator Signature / Date