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I
authorize AmeriCash Advance LLC to withdraw $20.00 from my account on
my original due date by EFT/ACH, as a fee for extension of payment of
the original advance plus fee ($120) that will still be owed
and due in full on the extended date shown above.
*I
agree that if this is my 5th or more extension of payment request of
my original advance, AmeriCash Advance is authorized by me to
automatically debit an additional $20 to be applied towards my balance
with each extension of payment request until the balance is paid in
full.
I
agree to maintain an adequate balance and keep my account(s) open to
allow all payments to AmeriCash Advance by EFT/ACH to occur in a
timely manner for the scheduled due date. If the payment is returned
for ANY reason, I agree that I will also pay a $25.00 return fee.
I
acknowledge all such transactions are made pursuant to the Master Cash
Advance Agreement, which has been previously executed and is on file
with AmeriCash Advance.
I
understand and agree. (Please
type your signature)
(submit my information for processing)
(this will delete information given)
Important:
If you do not receive
an e-mail of confirmation that your extension of payment request was
received and processed, this will mean it was not received by us and
your account is still scheduled to debit for the full balance due.
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