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

IMPORTANT INFORMATION ABOUT ELECTRONIC DOCUMENTSTo apply for a loan on-line, please review this information first to determine if you want to use electronic signatures and documents.

CONSENT TO USE ELECTRONIC DOCUMENTSWe use documents that are in “electronic form” for all loans and applications made through this website, regardless of whether an application is approved. "Electronic form” means that the documents are displayed on a computer screen instead of printed on a piece of paper, and sent back and forth over the Internet instead of by mail or private courier. These electronic documents include the account application, loan and/or extension request forms, loan agreements and disclosure statements, privacy notices, arbitration agreements, adverse action notices (statement of credit denial), and the military borrower identification statement appearing above. We will display all documents electronically through your web browser during the application process. If we must deny your loan request, we will send you an adverse action notice via U.S.P.S. mail. We encourage you to print and save copies of all of these documents. BY CHECKING THE BOX BELOW, YOU AGREE AND CONSENT TO THE USE OF DOCUMENTS IN ELECTRONIC FORM.

HARDWARE AND SOFTWARE REQUIREMENTSIn order to have access to electronic documents, you must have a computer or other device with Internet access and a web browser with 128bit SSL.

AVAILABILITY OF PAPER DOCUMENTSIf you do not wish to use electronic documents, you shouldapply at one of our many officesin lieu of applying on-line. If you have already applied on-line and wish to obtain paper copies of your documents, then you should submit a written request by mail to USA Cash Services, P.O. Box 150744, Ogden, UT 84415, together with a list of the specific documents requested. We will not charge you a fee for paper documents. Requesting paper copies of documents is not the same as withdrawing your consent to receive documents in electronic form.

WITHDRAWING CONSENT FOR ELECTRONIC DOCUMENTSYou may withdraw your consent to use electronic documents at any time and without charge. If you withdraw your consent, you may not use this website to obtain a loan from us. Withdrawing your consent will not affect the validity or enforceability of any documents or disclosures provided in electronic form before the notice is effective. Also, withdrawing your consent will not affect our rights under the loan agreement to debit your bank account to repay an outstanding loan.

1. If you have not completed your account application by clicking on the "FINAL SUBMIT" button, your consent will be automatically withdrawn. Any information you have entered on an incomplete application will be discarded.
2. If you have completed your account application and clicked on the "FINAL SUBMIT" button, you may withdraw your consent by sending an email to webmaster@USACashServices.com or by writing us at USA Cash Services, P.O. Box 150744, Ogden, UT 84415. You may also update your contact information in the same manner. Your withdrawal of consent will be effective when we receive it and have had a reasonable amount of time to act on it.
3. If you have withdrawn consent for electronic documents, but now wish to receive electronic documents, simply complete a new account application on-line.

REQUEST ELECTRONIC DOCUMENTS (and APPLY ONLINE!)By checking the box below, and/or by accessing this site using any password we may send you via email, you are consenting to receive documents in electronic form as described above. Your consent applies to all documents, notices and disclosures relating to this loan transaction (including those listed above) and all subsequent loan transactions using this website.