Loan applicant agrees and acknowledges that in the event any check and/or ACH issued by him/her is not honored by applicant's bank for
any reason including non-sufficient funds, closed account, stop payment, etc., there will be an automatic additional Return Item Fee of
$25.00 charged and due CQC, Inc. (Lender).   CQC, Inc. may exercise its option to accelerate upon any default by Borrower regardless of
prior forbearance.

In the event customer fails to honor loan agreement regardless of Security obtained by Lender, the account may be turned over for
collection, and/or legal civil action may be initiated to recover the amount due as detailed in the Loan Agreement.

I agree CQC, Inc. and/or their representative may contact any person listed on this Installment Payday Loan Application form or any other
persons having dealings with me in order to obtain information and/or discuss any debts which I owe CQC, Inc. to the extent not

prohibited by law.  I understand that CQC, Inc. may rely on other credit reporting agencies, including but not limited to Teletrack Inc®
and/or Veritec Services® to approve a Loan.  I waive any and all invasion of privacy claims against CQC, Inc.
CQC, Inc. dba Carbondale Quick Cash 820 E. Walnut St. Carbondale, IL 62901 Ph 618-351-6565

INSTALLMENT PAYDAY LOAN APPLICATION
Carbondale Quick Cash