By filling my full name in the Signature box below and submitting this
application, I hereby authorize Check Agencies of California, Inc. (CAC), to
verify all information I have given in connection with this payday loan or any
subsequent payday loan. I further authorize CAC to contact my employer, access
my account information, and contact references for purposes of verification or
collection of returned items. This authorization shall remain effective until a
written revocation is received by CAC.
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