Please READ, SIGN, and FAX back to: 1-877-250-3750 (Toll-Free)

To receive a payday advance you need to meet these simple requirements: You must have a net income (take home pay) of at least $200 per week. Along with this document you must send us the following information.

• A completed Online Application or Customer Information Sheet (Form #1)
• A copy of your personal check for $250.00 payable to Cash Advance Now, signed and dated. Or copy of your ATM/Debit Card (front and back); PLEASE PRINT CLEARLY and the ACH Authorization (call your bank to verify the information).
• A copy of your most recent bank statement (this statement must be dated within 30 days of the day you apply)
• Loan Agreement (Form #2).
• Wire Transfer* (Form #3). This form is optional.
• A copy of one form of state-issued picture identification (Driver's License or State ID)
• A copy of your last paycheck stub
• All forms must be signed (handwrite)

If we do not receive the above information with your application your loan will not be processed!

Your loan is due on the due date!

THIS IS A 15-DAY LOAN and you can extend by submitting an extension request at least 3 business days before your loan is due.

If your payment is returned to us for non-sufficient funds your account will be turned over to our Collections department. Your borrowing privileges will be TERMINATED with our company. Information on you and your account will be turned over to Scan and Telecheck services and your Check Writing privileges will be TERMINATED! Your information will be turned over to the credit bureau's delinquent account division.

THERE WILL BE A $25.00 RETURNED CHECK FEE ON EACH NON-SUFFICIENT ITEM RETURNED.

By signing this document you authorize Cash Advance Now to effect ACH debit and credit entries into the bank account submitted. In the event that your payments are returned unpaid for any reason, you authorize Cash Advance Now to effect ACH debit entries for the amounts of the checks or debit entries submitted with this agreement plus any accrued late fees or applicable late fees or applicable NSF charges.

DO NOT SIGN THIS DOCUMENT OR RECEIVE A PAYDAY LOAN BY PHONE UNLESS YOU UNDERSTAND OUR PROGRAM AND PROCEDURES FULLY. PLEASE CONSULT A CUSTOMER SERVICE REPRESENTATIVE TO ANSWER ANY QUESTIONS YOU MIGHT HAVE.