Welcome To Our Payday Loans No Fax Application Form. Personal Information Personal Information Continued Payday Loan Requested Amount -- Select -- $100.00 $200.00 $300.00 $400.00 $500.00 Are You Married Yes No First Name            Middle Name         Last Name                Spouse First Name   Spouse Middle Name Spouse Last Name    Address Apt# City State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Check one Rent Own         *Amount: At home address for years months Landlord/Mortgage Company Home Phone    Cellular Phone Email Address         Verify Email Address Loan approval will be sent by email DL  DL State SSN Have You Filed Bankruptcy Yes No If So When I prefer to be reached at home work email Birth date Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 Do You Have An Existing Faxless Payday Loan Yes No If Yes How many Payday Advance Loans 1 2 3 4 5 6 7 8 9 10 Total dollar amount of existing No Fax payday loans $0 $100 $200 $300 $400 $500 $600 $700 $800 $900 $1000 $1100 $1200 $1300 $1400 $1500 $1600 $1700 $1800 $1900 $2000 Employment Information Banking Information CompanyInstitution Your Position Work Address Suite City State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Main Phone          Direct Work Phone EXT Employment Duration years and months Pay Frequency Weekly Bi-weekly Monthly Semi-Monthly Pay Schedule  Weekly Every other Friday 15th and last 15th and 1st 5th and 20th Not Listed Tell us more - If not listed above.    Last Paycheck Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year 2010 Next Paycheck Date 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year 2010 2011 Monthly Net Income after taxes Supervisor Supervisor's Phone     EXT Human Resources Phone EXT Is your account Checking Savings Pre-Paid Debit Card How many overdrafts returned checks have   you had in the last 30 days What was your average Daily Balance What was your opening balance            $ What was your ending balance              $ Do you have Direct Deposit No Yes If Yes How Long Receiving Direct Deposit                  When Does Your Direct Deposit Post to your account Do you have Overdraft Protection Yes No Date Bank Account Was Opened Current Bank Check #  *Routing #: *Account # City State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Banks Phone References   Name:  Relationship: How Long Phone # Alt Phone #  Name:  *Relationship: How Long Phone # Alt Phone #  Name  Relationship How Long Phone # Alt Phone #  Name  Relationship How Long Phone # Alt Phone #  I hereby give permission for NeedInstant.com to verify the above information for a Loan. I also certify that the above information is true to the best of my knowledge. I Agree (Checking “I Agree” will be used as my electronic signature) *Date PLEASE READ CAREFULLY TERMS AND CONDITIONS I AM AWARE THAT THERE ARE SERIOUS PENALTIES FOR USING FALSE INFORMATION TO OBTAIN A FAST CASH ADVANCE PAYDAY LOAN TODAY ON THE INTERNET. I AM AWARE THAT MY IP ADDRESS IS BEING RECORDED AND WILL BE USED TO INVESTIGATE ANY CRIMINAL WRONG DOING IN REQUESTING CREDIT FOR A ONLINE CASH ADVANCE PAYDAY LOANS OR FAXLESS INSTANT CASH ADVANCE LOAN. THE INFORMATION THAT HAS BEEN GIVEN TO OBTAIN THIS FAST CASH PAYDAY LOAN IS MY OWN. THIS INFORMATION GIVEN HAS NOT BEEN CHANGED, ALTERED OR FALSIFIED IN ANY WAY TO OBTAIN A FAXLESS QUICK LOAN. I UNDERSTAND THAT NEEDINSTANTCASH.COM WILL TAKE THE MAXIMUM COURSE OF ACTION ALLOWED BY LAW ON ANY CRIMINAL ACTIVITY TO FALSELY OBTAIN A FAXLESS CASH ADVANCE LOAN. STOP PAYMENTS, REVOKED AUTHORIZATIONS, CLOSED/FROZEN ACCOUNTS WILL IMMEDIATELY ACCRUE ATTORNEY/COURT/COLLECTION FEES/COSTS IN ADDITION TO THE MAXIMUM COURSE OF ACTION ALLOWED BY LAW TO COLLECT THE DEBT OWED FOR OBTAINING THE FAXLESS INSTANT CASH ADVANCE LOAN OR INSTANT NO FAX PAYDAY LOAN OR QUICK LOAN. RETURNED CHECKS: IT IS YOUR RESPONSIBILITY TO CONTACT NEED INSTANT CASH.COM WITHIN 72 HOURS OF ANY RETURNED/UNFUNDED FAXLESS CASH LOANS OR FAXLESS PAYDAY CASH ADVANCE LOAN TRANSACTIONS. YOU WILL NOT BE CONTACTED BY OUR OFFICE IN REGARDS TO RETURNED FAXLESS CASH ADVANCE LOAN TRANSACTIONS AS IT IS YOUR RESPONSIBILITY TO MAKE ARRANGEMENTS TO PAYOFF YOUR ONLINE CASH ADVANCE PAYDAY LOANS ACCOUNT. NEED INSTANT CASH.COM WILL NOT "HOLD" YOUR ACCOUNT WITHOUT HEARING FROM YOU AND WILL TAKE TO MAXIMUM COURSE OF ACTION, ALLOWED BY LAW, TO COLLECT ANY DEBTS OWED PERTAINING TO YOUR FAXLESS NO FAX PAYDAY ADVANCE LOAN. ALL CUSTOMERS, HEREIN REFERRED TO AS "UNDERSIGNED", "YOUR" AND "I", OF NEED INSTANT CASH.COM HAVE THE OPTION FOR A PAYDAY ADVANCE LOAN EXTENSIONS. YOUR FAXLESS SHORT TERM LOAN ACCOUNT WILL BE AUTOMATICALLY SET UP FOR A FAXLESS CASH ADVANCE EXTENSION. UNLESS NEED INSTANT CASH.COM IS CONTACTED WITHIN 72 HOURS OF PAYMENT AND TOLD TO PAY OUT THE FULL NO FAX CASH ADVANCE INSTANT ONLINE PAYDAY LOAN OR PAY OVER THE PAYDAY CASH ADVANCE LOAN EXTENSION AMOUNT, AN EXTENSION FEE WILL BE DEBITED FROM YOUR ACCOUNT. A PAYDAY CASH ADVANCE LOAN EXTENSION EXTENDS YOUR CASH ADVANCE PAYDAY LOAN UNTIL YOUR NEXT PAYDAY. UNLESS ADDITIONAL MONEY IS PAID OVER YOUR LOAN OR THE EXTENSION AMOUNT THE FAXLESS CASH ADVANCE LOAN AND FEE WILL STILL BE DUE WHEN YOU DO PAY OFF. WE PROVIDE A SMALL LOAN FOR PEOPLE WITH BAD CREDIT OR NO CREDIT. A NO CREDIT UNSECURED PERSONAL LOAN DOES NOT REQUIRE ANY COLLATERAL TO OBTAIN MONEY. BY SIGNING BELOW, I AGREE AND AM AWARE, THAT MY ACCOUNT WILL CONTINUE TO BE DEBITED THE FAXLESS LOAN ADVANCE EXTENSION AMOUNT UNTIL MONEY PAID OVER THE LOAN OR THE FAXLESS CASH ADVANCE LOAN EXTENSION BRINGS THE BALANCE TO $0 OR A FINAL PAYMENT OF THE ORIGINAL ADVANCED LOAN AMOUNT AND FEE ARE MADE. LATE FEES: THERE WILL BE A $50.00 LATE FEE ADDED ONTO THE FACE VALUE OF THE FAXLESS LOAN ADVANCE FOR ANY PAYMENTS PROCESSED AFTER THE INSTANT CASH ADVANCE LOAN DUE DATE. BY SIGNING BELOW, I AGREE THAT MY BANKING ACCOUNT IS CURRENTLY IN GOOD STANDING AND I DO NOT HAVE A NEGATIVE BALANCE. I AM NOT IN THE PROCESS OF FILING BANKRUPTCY AND HAVE NO INTENTION OF DOING SO AT THE PRESENT TIME WHILE OBTAINING THE PAYDAY CASH ADVANCE LOAN OR INSTANT APPROVAL PAYDAY LOAN. THE UNDERSIGNED, AGREES TO PAY THE FULL AMOUNT BORROWED, IN ADDITION TO ADDITIONAL FEES, EXTENSIONS, RETURNED CHECK FEES AND/OR ATTORNEY/COURT/COLLECTION CHARGES ACCRUED UNTIL THE BALANCE OF ACCOUNT IS PAID IN FULL TO THE ABOVE MENTION, NEEDINSTANTCASH.COM. The undersigned has been advised of balance of account and payday cash advance loan extension amount and policies and by signing below accepts full responsibility for balance due and any fees accrued. The undersigned is aware that NEEDINSTANTCASH.COM will take the MAXIMUM COURSE OF ACTION allowed by law to collect any remaining debt owed to NEEDINSTANTCASH.COM. The undersigned, agrees to pay any and all attorney/court/collection fees accrued by NEEDINSTANTCASH.COM to collect debt owed for an advance. I HAVE READ AND UNDERSTAND THE ABOVE TERMS FOR APPLYING FOR A INSTANT NO FAX PAYDAY LOAN. BY SIGNING BELOW, I AGREE THAT ALL INFORMATION SENT TO NEEDINSTANTCASH.COM IS TRUE AND CORRECT. I GRANT PERMISSION TO NEEDINSTANTCASH.COM TO VERIFY AND/OR CONTACT ANY INFORMATION PROVIDED ON THE APPLICATION FOR PURPOSES OF APPROVING THE INSTANT CASH ADVANCE LOAN AND/OR COLLECTION PROCEEDINGS. I, THE UNDERSIGNED, AGREE TO ALLOW NEEDINSTANTCASH.COM TO DEBIT MY ACCOUNT FOR THE EXISTING ONLINE CASH ADVANCE PAYDAY LOANS ON THE DATE NOTED IN MY APPROVAL EMAIL AND EACH CASH ADVANCE LOAN EXTENSION THERE AFTER UNTIL THE NO FAX PAYDAY ADVANCE LOAN IS PAID TO A $0 BALANCE.           Signature (typed name)                        *Date