Loan applicant(s) agrees and acknowledges that in the event any item issued by him/her is not honored by
applicant's bank for any reason including non-sufficient funds, closed account, stop payment, etc., there will be
an automatic additional Return Item Fee of $25.00 charged and due.
In the event customer fails to honor loan agreement regardless of Security obtained by Lender, the account
may be turned over for collection, repossession, and/or legal action may be initiated to recover the amount due
as detailed in the Loan Agreement.
I/We agree Harrisburg Quick Cash, Inc. and/or their representative may contact any person listed on this
Installment Loan Application form or any other persons having dealings with me in order to obtain information
and/or discuss any debts which I owe Harrisburg Quick Cash, Inc. to the extent not prohibited by law. I/We
understand that Harrisburg Quick Cash, Inc. may rely on other credit reporting agencies, including but not
limited to Teletrack Inc® and/or Veritec Services® to approve a Loan. I/We waive any and all invasion of
privacy claims against Harrisburg Quick Cash, Inc.
| Harrisburg Quick Cash 114 S. Commercial Harrisburg, IL 62946 Ph 618-253-6565 CONSUMER INSTALLMENT LOAN APPLICATION (205 ILCS 670/1 et seq) |