About You
Please provide some basic information about yourself so that our experts can pair you with a lender. We protect your information using encryption technology. Our website is secured via SSL encryption technology and strict privacy policies. With our advanced security measures, you can be assured that your information will remain safe and secure.

First Name:
Last Name:
Daytime Phone:
Driver's License Number:
Driver's License State:
Date of Birth:
Social Security Number:
Are you, your spouse, or someone upon whom you are dependent active in the US Military?
Employment Information
As your job is a form of collateral for the loan, we need to verify that you are currently employed. Lenders will not contact your employer unless necessary, but may ask for a pay stub. Review their terms prior to taking out a loan.
Employment type:
Employer's phone:
Length of employment:
Payment schedule:
Amount of last paycheck:
Next two pay dates:
Method of Payment:
Financial Information
Your bank account and routing numbers are required for the lenders to deposit money into your account. All of your information is kept secure using advanced SSL encryption.
Desired loan amount: $  
Type of account:
ABA Routing Number (?):
ABA Numbers

Account Number (?):
ABA Numbers

Please provide two personal references
(Optional) Lenders will not contact your personal
references unless absolutely necessary.
Review the lenders' terms prior to taking out a loan.
First Name:
Last Name:
First Name:
Last Name:
Need assistance taking out a loan? Give us a call, toll free: 855-978-0274
The operator of this website is not a lender.
This site will share the form information provided by the consumer with one or more lenders.
This site can find you a cash advance lender based on your form and lender requirements.
Not all customers will be connected to a lender, and not all customers will be approved by a lender.
Payday-Loan-Superstore cannot guarantee the amount of funds that may be extended if a lender approves the form.
*Not all lenders can provide up to $1,000. Consumer loan amounts vary bases on creditworthiness.
Lenders tend to provide upper range loan amounts to returning customers. Cash transfer time may vary between lenders.
Funds are not available until the next business day. Cash advances are not available in all states.
Lenders may undertake credit checks or otherwise verify the consumer’s social security number or other information.
If and when lenders preform credit checks they are ran via specialized credit bureaus.
Late payments of loans may result in additional fees or collection activities, or both.
Non-payment of credit could result in collection activities.
Each Lender has their own terms and conditions, please review their policies for further information.
Every Lender has its own renewal policy, which may differ from Lender to Lender. Please review your Lender’s renewal policy.

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