I certify that I am at least 18 years of age; or I am a resident of Alabama or Nebraska and I am at least 19 years of age; or I am a married resident of Alabama and I am at least 18 years of age.
I authorize Advance America and Lender to perform credit checks, searches and/or analysis of data in certain state-required databases, as well as other commercially available and/or proprietary databases, in order to identify consumers who have a record of transactions with certain lending institutions to verify truthfulness or accuracy of my information, and/or to determine whether or not I qualify for a loan or advance.
RESIDENTS OF CA AND UT: I acknowledge that I have received notice that a negative credit report reflecting on my credit record may be submitted to a credit-reporting agency if I fail to fulfill the terms of my credit obligations.
RESIDENTS OF DE: I acknowledge that (1) the loan is designed as a short-term cash flow solution and not designed for longer term financial problems; (2) additional fees may accrue if the loan is rolled over; and (3) credit counseling services are available to consumers who are experiencing financial problems.
RESIDENTS OF OH: Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers, and that credit-reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.
RESIDENTS OF MO: Ability to repay: We are required by law to consider your ability to repay the loan, including the renewals you can take out to pay the loan off over time. As such, we will never loan you more than 55% of your gross monthly income. Further, we will not and cannot make a loan to you that we do not reasonably believe could be paid by you over the course of the loan and renewals. We will consider the data we have available about you to make our decision and reserve the right to ask for more information if necessary. Renewals: You are allowed the maximum number of renewals allowed by law. That number is currently six renewals. If you renew a loan, you are allowed to pay the interest on the loan plus as little as $25 toward the principal you borrowed. In other words, if you borrow $100, and the interest on the loan is $20, you can pay the $20 in interest plus $25 towards principal. If you pay the $45, your loan will be renewed and you will owe $75 plus interest the next time your loan is due. You can also pay the interest plus more of the principal if you want to pay off the loan sooner. We cannot charge you more than 75% of the amount you borrowed in interest over the life of the loan. In other words, if you borrow $100, we cannot charge you more than $75 in interest during all renewals of the loan.
RESIDENTS OF WI: NOTICE TO MARRIED APPLICANTS: No provision of a marital property agreement, a unilateral statement under section 766.59 or a court decree under section 766.70 adversely affects the interest of the creditor unless the creditor, prior to the time the credit is granted, is furnished a copy of the agreement, statement or decree or has actual knowledge of the adverse provision when the obligation to the creditor is incurred. I understand that I may select an individual or joint account with Lender (if I qualify) and have voluntarily selected the type of account above.
RESIDENTS OF WA: At the time you repay this loan, you should have sufficient funds to meet your other financial obligations. If you cannot pay other bills because you are paying off this debt, you should enter the installment plan offered in connection with this loan (WAC 208-630-560(3).
You warrant that all of the information you have provided to us in this form is true, correct and complete.