Elite Cash Wire - Apply For A Short Term Pay Day Loan

Telephone numbers must be exactly 10 digits, and social security must be exactly 9 numbers. No spaces, dashes or parentheses.

Personal Information

First Name

Last Name

Gender Male Female

Home Address

City

Province

Postal Code

Do you Rent Own House

How long at this address (No of months)? Months

Email Address

Telephone

Cell Number (optional)

Alternate Number

Birth Date

SIN (no spaces or dashes)

Driver License #

Employment Information

Are you currently employed, and have been for three months? Yes No

How many hours do you work per shift? (per day)

Company Name

Job Title

Work Number

Date Hired

Main source of your income

How often do you receive a paycheck? (must match the paycheck dates below) Weekly BiWeekly Monthly TwiceMonthly

How do you receive your pay?

Monthly Pay

Date of your next paycheck

Date of paycheck after next

Bank Information

Do you have an active checking account? Yes No

Bank name

Bank branch number

Bank account number

Bank institution number

How long have you had your account at this bank (No. of Months)? Months

Requested loan amount

References

First reference's full name

Second reference's full name

First reference's phone number

Second reference's phone number

First reference's relationship

Second reference's relationship

By checking "I consent", I understand and agree that my personal information may be shared with potential lenders, and I hereby authorize any such potential lenders to verify the accuracy of the information I have provided by, among other actions, checking my credit report. Terms and conditions By clicking the "Click for Cash" button on this page, I certify that I have read and agree to the practices set forth in the EliteCashWire.com Privacy Policy and Terms of Use Agreement, which includes receiving newsletters and/or emails from us and/or phone calls (including pre-recorded calls) from this list of Marketing Partners at the telephone number(s) provided. I also confirm and certify that I am at least 18 years of age. Click to View Terms.

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*EliteCashWire.com is an advertising agency only, not a financial institution or lender. EliteCashWire.com will place you with one of several loan providers depending on the information you submit on this website. Not all lenders can provide up to $1000. Cash transfer time may vary between lenders. Please be sure to review the terms and conditions of each service prior to doing business with them as Cash Advance charges vary by lender. This service does not constitute an offer or solicitation for short term loans in every state and may or may not be available in your particular state. The states in which this service is available may change from time to time without notice.

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This site will match you with the best cash advance lender based on your application. Not all lenders can provide up to $1000.

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Elite Cash Wire is currently communicating with over 1000 lenders on your behalf to get the loan you want so please be patient while we find a bank that is right for you. This may take a several minutes. Please do not close your browser or you will lose your chance to get money from Elite Cash Wire today.