Account Information:

Please fill out the check below. When we receive it, we will process your cash advance.

If any of your personal information has changed since your last loan, please click here to update it, otherwise, your loan may not be processed.

Access EZ Cash, Inc. is authorized to withdraw the amount selected on the check from my checking account on the DATE indicated above. I understand and agree to pay $15 if the check is returned for ANY reason. Furthermore, I authorize Access EZ Cash, Inc. to initiate either the whole amount or portions of the amount until fully paid. These partial payments may be originated at any time after the original due date. This activity shall remain in full force and effect until my financial institution and Access EZ Cash, Inc. have received, in writing, a notice of its termination of at least 30-days prior to the date of termination. If I wish to pay this item before the due date, I acknowledge that such payments must be made at least two (2) days before the due date, not counting weekends or bank holidays. I also authorize Access EZ Cash, Inc. to run a credit report through TeleTrack to approve my account.

By typing your name in the following box, you acknowledge that you have read the Truth in Lending Agreement.