EX-4.3 5 cps_s2a1ex4-3.txt Exhibit 4.3 CONSUMER PORTFOLIO SERVICES, INC. 16355 Laguna Canyon Road Irvine, California 92618 PURCHASE CONFIRMATION [Investor name and address] STATEMENT DATE: __________,200___ TRANSACTION INFORMATION ----------------------- SECURITY DESCRIPTION: Consumer Portfolio Services, Inc. Renewable Unsecured Subordinated Note TRANSACTION: PURCHASE TYPE OF OWNERSHIP: ____________ SSN: ____________________ NOTE ID TERM PURCHASE DATE MATURITY DATE PAYMENT SCHEDULE ------- ---- ------------- ------------- ----------------- PRINCIPAL AMOUNT INTEREST RATE COMMISSION/FEES NET AMOUNT ---------------- ------------- --------------- ---------- NOTE: These securities are issued in book-entry form only; no physical certificates will be provided. INTEREST PAYMENT INFORMATION ---------------------------- ACCOUNT NAME: BANK: ACCOUNT #: ROUTING NUMBER: INTEREST PAYMENT METHOD: ACH (Direct Deposit) FOR FURTHER CREDET: Your interest payments will be automatically deposited directly into the account listed above. Please verify the account information. If it is incorrect, please call Sumner Harrington Investor Services at 800-234-5777. All interest payments will be made in accordance with the Interest payment schedule shown in the previous section. If your note pays interest monthly and the monthly interest payment date you selected is within five business days of the Purchase Date, your first interest payment will be made the following month and will include all of the interest earned since the Note Issue Date. If an interest payment date falls on a Saturday, Sunday, or legal holiday, the payment will be made on the next business day. SECURITIES OFFERED THROUGH SUMNER HARRINGTON LTD. ------------------------------------------------- Sumner Harrington Ltd. was the selling agent for the Issuer in this transaction and is sending you this confirmation statement on the Issuer's behalf. The Issuer will pay Sumner Harrington Ltd. a commission of up to 3% of the Net Amount plus other fees for its role in this transaction. PLEASE CALL SUMNER HARRINGTON LTD. INVESTOR SERVICES AT 800-234-5777 IF YOU HAVE ANY QUESTIONS. Sumner Harrington Ltd. (800) 234-5777 11100 Wayzata Blvd., Suite 170 investorservices@sumnerharrington.com Minneapolis, MN 55305 www.sumnerharrington.com