Loan applicant agrees and acknowledges that in the event any check and/or ACH 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 there is no Check
and/or ACH associated with my loan, and my payments are not made in a timely manner as shown on the Loan
Agreement, I understand that CQC, Inc. may require Borrower to immediately repay the entire unpaid Total of
Payments less any required refunds. CQC, Inc. may exercise its option to accelerate upon any default by
Borrower regardless of prior forbearance.
In the event customer fails to honor loan agreement regardless of Security obtained by Lender, the account
may be turned over for collection, and/or legal action may be initiated to recover the amount due as detailed in
the Loan Agreement.
I agree CQC, 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 CQC, Inc. to the extent not prohibited by law. I understand that CQC, Inc. may rely on other credit
reporting agencies, including but not limited to Teletrack Inc® and/or Veritec Services® to approve a Loan. I
waive any and all invasion of privacy claims against CQC, Inc.
| CQC, Inc. dba Carbondale Quick Cash 820 E. Walnut St. Carbondale, IL 62901 Ph 618-351-6565 CONSUMER INSTALLMENT LOAN APPLICATION (205 ILCS 670/1 et seq) |
