Advance Pay Day

Electronic Transfer to Checking

	LOGIN \| MY ACCOUNT
	Licensed by the Department of Corporations Pursuant to the California Deferred Deposit Transaction Law Click here to view License

FUNDS WILL BE DEPOSITED INTO YOUR ACCOUNT WITHIN 48 HOURS Any questions please call us at 949-477-9600
First , Please enter your desired loan amount: $ (Maximum Loan Amount $255)
Enter date of next payday: mo - day - year (No Holidays or Weekends)

ADVANCE PAYDAY, INC. EVIDENCE of CHECK

		Date:

First Name:		Last Name:
Address:
City:		State:	Zip Code:

Pay to the order of:

In the amount of: $
		Dollars

Bank Name:
Address:
City:		State:	Zip Code:

Routing Number:		Account Number:

By submitting this agreement, you are authorizing the electronic equivalent of your signature.

Advance Payday, Inc. is registered with the California Department of Corporations pursuant to the California Deferred Deposit Transaction Law. If you submit this Evidence of Check (hereafter referred to as "EOC") via the internet to us, we will receive and process it the same as if you submitted it to us in person. Submission of this EOC, and the information provided, constitutes the electronic equivalent of your personal check. In addition, you represent and agree that all information you provide on the EOC is accurate, current and complete, and that you have the right to provide such information to us. You agree to not misrepresent your identity or your account information. You agree to keep your account information up to date and accurate.


By submitting to this agreement, you are authorizing the electronic equivalent of your signature.

	I have read and AGREED to the Deferred Deposit Agreement & Disclosure Statement above.

COVERED BORROWER IDENTIFICATION STATEMENT
Federal law provides important protections to active duty members of the Armed Forces and their dependents. To ensure that these protections are provided to eligible applicants, we require you to sign one of the following statements as applicable:

	I AM a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specific a period of 30 days or fewer.

	I AM a dependent of a member of the Armed Forces on active duty as described above, because I am the member’s spouse, the member’s child under the age of eighteen years old, or I am an individual for whom the member provided more than one-half of my financial support for 108 days immediately preceding today’s date.

	I AM NOT a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer (or a dependent of such member).

	Warning: It is important to fill out this form accurately. Knowingly making a false statement on a credit application is a crime.

By submitting to the "Covered Borrower Identification Statement", I acknowledge I received and I am "NOT" an active member of the Armed Forces.





DEFERRED DEPOSIT AGREEMENT & DISCLOSURE STATEMENT

Advance Number:41494

Advance Date: 02-22-2012

Payment Due:

    Lender:
    ADVANCE PAYDAY, INC.
    2272 Michelson Drive, Suite 108
    Irvine, CA 92612
    (949)477-9600

Borrower:
First Name:
Address:
State:
Social Security Number:

Last Name:
City:
Zip Code:
***-**-**

Disclosures Under Federal Reserve Regulation

ANNUAL PERCENTAGE RATE The cost of your credit as a yearly rate.	FINANCE CHARGE The dollar amount the credit will cost you.	AMOUNT FINANCED The amount of credit provided to you or on your behalf.	TOTAL PAYMENT The amount you will have paid after you have made all payments as scheduled.
Payment Schedule One payment of is due on		Prepayment: If you pay off early, you will not be entitled to a refund of any part of the finance charge.
Security Interest: You are granting us security interest in the check reference above.
Amount paid directly to you

AGREEMENT

Deferred Deposit: You acknowledge receipt of the “Amount Paid Directly to You” and agree that we may defer deposit of your check, until the Payment Due Date indicated above. The check is being negotiated as part of the deferred deposit transaction made pursuant to Section 23035 of the Financial Code and is not subject to the provisions of Section 1719 of the Civil Code. At its sole option, Advance Payday, Inc. (“we” or “us”) may electronically debit your Account on the Payment Due Day. You acknowledge and represent that you have no outstanding Deferred Deposit Agreement with us. You agree not to stop payment on the Check or take any other action that would prevent your Financial Institution from paying the Check on or after the payment due day. We can not be responsible in any manner for fees or changes incurred by you for late deposits into your bank account.
No Collateral: This Agreement is not secured by any collateral except our security interest in your Check.
Collection: You understand and agree that if, for any reason, your Financial Institution returns your check unpaid, we may pursue all available civil remedies against you to collect the amount you owe us. In the event your Check is returned unpaid for insufficient funds, you agree (a) to pay us a returned check charge of $15.00, and (b) that we may represent your Check in paper form ir electronically. This authorization will remain in force until we have had a reasonable opportunity to act on this authorization. If, at any time when you owe us money, (a) you present any check(s) to us for negotiation, we may apply the amount of such check(s), to the amount you owe us, (b) or we may debit your account electronically for any amounts you owe us. No customer may be required to pay treble damages.
Privacy Policy: We do not disclose any non-public personal information about our customers to anyone, except as permitted by law. Customer may direct any complains and concerns regarding this agreement to the Department of Corporations toll-free telephone number 866-275-2677.
Governing Law: This Agreement is governed by the laws of the State of California. If any provision of the Agreement is held to be unenforceable, the remainder of this Agreement shall remain in full force and effect.
Other Disclosures: You cannot be prosecuted, or threaten with prosecution, in a criminal action in conjunction with a deferred deposit transaction for a returned check. You cannot be prosecuted or threaten with prosecution to collect. The deferred deposit transaction is not contingent on the purchase of another product or service.

X-------------------------	02/22/2012 Date	Advance Payday, Inc. X-------------------------	02/22/2012 Date
Customer Signature(s)		Authorized Representative