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DISCLOSURE
No. ________________ Transaction Date ________________ Creditor: Customer:
CASH 4 CHECKS, Inc. and Xxxxxxxx Xxxxxxxxxxxxx Affiliates Any Street c/o FEI Any Town Ph: (XXX) XXX-XXXX Social Security Number: XXX-XX=XXXX In this CHECK CASHING DEFFERED DEPOSIT AGREEMENT (the Agreement). The words you, your, I, and my mean each customer identified. The words we, us, our, and company mean CASH 4 CHECKS, INC., FAAS ENTERPRISES, INC. (d.b.a. CHECK CASHING CENTER) which any one or more is the creditor in this transaction. AGREEMENT Simultaneous with the execution of this Agreement, (a) you have delivered to us at our address set forth below your check(s) numbered __________ in the aggregate amount of $___________ (the check(s)), (b) we have cashed the check(s) and given you cash proceeds in the amount of $_______, and (c) we have agreed to hold the Check(s) until the Payment Due Date set forth below before depositing the Check(s). In consideration for our cashing the Check(s), you agree to pay us a fee of $________ at the same time that this Agreement is executed. You agree that the account on which the Check(s) is/are drawn will have sufficient funds on the Payment Due Date to pay the Check(s). You further agree not to stop payment on the Check(s) or to take any action that will result in the failure of your financial institution to pay the Check(s) on the Payment Due Date. DISCLOSURE
Finance Fee Amount Total Check(s) Rate Charged Financed Amount The cost of your credit The dollar amount the The amount of credit The amount you have paid at a yearly rate. credit will cost you. provided to you or on at the completion of this Your behalf. Agreement XXXXXX% $XXXXX $XXXXX $XXXXXX
This is a fee based advance. I authorize CASH 4 CHECKS, INC., FAAS ENTERPRISES, INC. (d.b.a. CHECK CASHING CENTER) to cash my check(s) and defer the deposit of the check(s) until the date stated above (not to exceed 16 days). I acknowledge and represent that I have no outstanding payroll advance or deferred deposit check(s) with any location of CASH 4 CHECKS or its affiliates. I hereby authorize this transaction to be electronically submitted to my bank and acknowledge my check(s) will not be returned to me. I hereby further authorize you to initiate debits/credit entries to my account for all payments due under this Agreement, including unpaid return items from my financial institution, unpaid returned items fees, and any fees, costs, or expenses, and collections permissible by California law, including a $15.00 returned check or electronic debit fee. This authorization shall remain in full force and effect until my financial institution and the Company have received, in writing, by certified mail, a notice of termination at least 30 days prior to the date of termination. A fee not to exceed $15.00 my be charged for each and every returned check or item. Itemization of Amount Financed: The Amount Financed of $_________ will all be given to you directly. Prepaid Finance Charge: $__________. You have read, understood and agreed to the above and to the Additional Terms of Agreement on the reverse side of this page. You acknowledge receipt of the proceeds of the cashed Check(s) in the amount identified above. CUSTOMER(s) CASH 4 CHECKS. INC. Location: __________ Signature: __________________________ Signature: __________________________ By: _______________________ Agent Representative
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