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This form lets you start the process for a loan with CashMax Title & Loan. It’s FREE to get started and your information will be kept secure and private.

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Loan Type

Loan Amount

First Name

Last Name

Email Address

Home Phone

Mobile Phone

How many years have you had this mobile number?

SMS Opt In

*I agree that CashMax and its authorized representatives may contact me about special offers by calling or texting me at any number provided including cell phone, with an auto dialer or pre-recorded message. *Message and data rates may apply.

Mailing Address

Address Line 1

City

State

Zip Code

How long have you lived at this address?

Do you rent or own your home?

Net Monthly Income

Employer

Employer Phone

Date Of Hire

Are you a regular or reserve member? (Leave Unchecked If You Are)

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 fewer.

Are you a dependent of a member of the Armed Forces on active duty? (Leave Unchecked If You Are)

I AM NOT a dependent of a member of the Armed Forces on active duty as described above, because I am the member's spouse, the member's child under the age of eighteen years old, or I am an individual for whom the member provided more than one-half of my financial support for 180 days immediately preceding today's date.

Are You 18 or Older

By checking this box you are indicating that you are 18 years of age or older. I am 18 years of age or older.

This form lets you start the process for a loan with CashMax Title & Loan. Before a loan decision is made, a store CashMax representative will verify your identity and documents submitted by you during the loan application process. It’s FREE to get started and your information will be kept secure and private.

Terms Agreement

I have read and agreed to the terms provided in the below link before submitting this application.

ARBITRATION: Arbitration is a means for legal matters between parties to be resolved by a neutral arbitrator rather than a Court. This Company has a policy of arbitrating all claims, demands, and disputes which cannot be resolved in a small claims tribunal, including the scope and validity of the arbitration provision and any right you may have to participate in an alleged class action. Whether or not you enter into an installment loan with us, this arbitration provision governs the resolution of disputes. You agree that YOU ARE WAIVING YOUR RIGHT TO HAVE A TRIAL BY JURY to resolve disputes against us, our agents and/or owners.

RELEASE OF INFORMATION TO FEDERAL CASH ADVANCE OF OKLAHOMA, LLC: (Please read statement before signing.) I promise that information I have provided on this form is correct. I authorize complete verification of all information I have provided as well as understand that this information may be used to verify certain past and/or current credit or payment history information from third party source(s). You may contact any person or company listed above, and I fully release all parties from all liability for any damages that may result. My signature below indicates that for purposes or verification I voluntarily waive the protection of all privacy laws and affirmatively authorize Federal Cash Advance of Oklahoma, LLC, OBA CASH MAX to disclose the information on this form and any additional information it may have collected about me to third parties as necessary to arrange on my behalf financial services or products that Federal Cash Advance of Oklahoma, LLC, OBA CASHMAX offers from those third parties. This application may be rejected if any information provided above is found to be false.

CUSTOMER DISCLOSURES: This Credit Services and Loan Application ("Application") is not a promise services or obtain a loan. This application will be used by us for underwriting our credit services as well as by the third party lender, NCP Finance L.P.("Lender") for loan underwriting.

CSO Disclosure and Loan Terms: Federal Cash Advance of Oklahoma, LLC, OBA CASHMAX is a registered Texas credit service organization. Our services include assisting you in the arranging, processing, and servicing of a loan from a third art lender.

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