QUICK MONEY LTD. PAYDAY LOAN APPLICATION

Kindly fill up this form to the best of your knowledge so that we can know you and serve you better!

PERSONAL INFORMATION:

First & Middle Name*

Last Name*

Your E-mail*

Date of Birth*

Cell Phone Number*

Home Phone Number

Address*

City, Postal Code, Province*

Photo ID* (please attach a picture of your photo id)

Employer's Name*

Supervisor's Name*

Supervisor's Phone Number

Work Phone Number*

Department*

Position*

Working since*

Full TimePart Time

Work Address*

City, Postal Code, Province*

What day do you get paid?*

WeeklyBi-WeeklyTwice-MonthlyMonthly

Net Pay*

Date of Last Pay*

Date of Next Pay*

Void Cheque* (please attach a picture of your void cheque)

Bank Statement* (please attach 30 days of bank statement, one or multiple files if required)

File 1
File 2
File 3
File 4

Full Name*

Date*

Signature* (please attach a picture of your signature)

(please wait for the application to upload)

Quick Money Ltd. provides fast, easy and confidential payday loans. We offer professional and friendly customer service.

Talk to our friendly staff about your financial needs!

(This information is required under the Payday Loans Act, 2008)

Maximum Allowable Cost
per $100 Borrowed:
$15

Our cost per $100 Borrowed:
$15

Example: Your $300 loan for 14 days

Amount Advanced: $300.00

Total Cost of Borrowing: $45.00
________________________

Total You Repay: $345.00

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