First Name: *
Last Name: *
Email Address: *
Street Address:
City:
State	South Carolina North Carolina
Zip Code:
Mobile Phone or Contact Phone:
Preferred Contact Time:	Anytime Day Time After 5pm
Social Sec #:
PLEASE READ BEFORE PROCEEDING: By clicking the Submit button I hereby authorize Checks America Payday and its affiliates to use my personal and confidential information in any manner consistent with the Checks America Payday privacy policy which can be viewed by clicking the applicable link at the bottom of this web page. I certify that the information supplied by me is true and correct. I authorize verification of the truthfulness of all information contained herein, including verification of income and banking information. I expressly authorize contact with any person or company identified above to verify any of the above information or to leave a message for me. Any false statement made by me shall be sufficient basis for rejection. I have read and understand the above statements. I acknowledge that this application and any supporting documentation provided with it is the property of Checks America Payday. I represent that I am neither a current nor a former Checks America Payday employee nor am I a spouse or relative of a current or former employee. I attest that 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 less. Nor am I an Active Guard and/or Reserve member of the military currently serving on active duty or who has served on active duty within the past 180 days, nor am I a spouse, child, or other dependent person who derives more than one-half of my monetary support from a member of the military who is on active duty or has been on active duty within the past 180 days. We must submit your Social Security Number to the State of South Carolina Database for Deferred Presentment Lenders to check your eligiblity before processing your application. I authorize Checks America Payday to perform credit checks, searches and/or analysis of data in certain state-required databases as well as other commercially available and/or proprietary databases in order to identify consumers who have a record of transactions with certain lending institutions and/or establish my creditworthiness. I certify that I am at least 18 years of age; I also understand that I must visit one of Checks America Payday local offices to sign the documents and pick up the proceeds of the loan if I am approved. Checks America Payday does not offer internet loans. By Submitting this application, I agree to the Terms, Notices, and Disclosures:
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Click Here If You Need A Car Title Loan.

Checks America Payday Advances, Inc. can serve your Car Title Loan and Payday Loan needs at our local retail offices in: Rock Hill, South Carolina office conveniently located to the greater Charlotte, North Carolina area; Anderson, South Carolina office located in the Greenville, South Carolina that serves all of upstate South Carolina. We also have a Clover, South Carolina office conveniently located to Gastonia, North Carolina. Our new office located on Carowinds Blvd serves all of Charlotte, North Carolina.