Smartaxx PreSeason Christmas Advance Loan

SMARTAXX CHRISTMAS LOAN ADVANCE FORM

Unlock the Magic of the Season with Our December Dollars Advance
You asked and we delivered!

Qualify for a pre-approval for the in-season advances, that starts in December. Get a FREE estimate with your last 2 paystubs!

See if you qualify today.

Dates: Starts on December 16th - December 31st

Advance Amount: $100 - $300 (Republic Bank)

Get paid via Netspend Visa or Direct Deposit

Come and see the Tax Goat's!! Tis the season to see what Smartaxx can do for you!

To receive pre-approval for the December Dollars Advance, you must meet the prior year's funding and loan loss requirements.
Full Name*

First NameMiddle InitialLast NameSuffix
Date of Birth*

MonthDayYear

SPOUSE INFORMATION
Spouses Full Name- Include Middle Initial

First NameMiddle InitialLast NameSuffix
Spouses Social Security #
(111-11-1111)
Spouse Occupation/Role
Spouse Date of Birth

MonthDayYear
Date
Spouse Phone #
Spouse Email Address
example@example.com

Please list Dependents- If married filing joint please list spouse dependent information

TAX INFORMATION
The IRS implemented ID.Me in 2022. This is to protect all taxpayers identity. Do you have an ID.Me account with the IRS? If no, after submitting this form, please visit IRS.gov to set up your ID.Me account.
Did you receive unemployment?*
Do you owe any debt that could possibly affect your refund? If so, Explain.
Upload your last two paystubs here:

Accepted files: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
Cancelof
How did you hear about us?*
Who was the client who recommended you?*
INCLUDE FIRST & LAST NAME PLEASE
Other
Financial Institution
Name of Bank
Type of Account

CheckingSavings

Routing and Account Number

	Bank info below
Account #
Routing #

Please give us two people you want to refer to gain up to $100

	First Name	Contact Number	Email Address
1
2

ACKNOWLEDGEMENT
1 EROs must be enrolled for Republic Bank's Refund Transfer Program and meet prior year funding and loan loss requirements to offer the December Dollars Advance. Cost to ERO per approved December Dollars Advance will be deducted from ERO tax preparation fees and cannot be passed to the taxpayer. If approved, a Finance Charge will apply to the Taxpayer. Net Refund refers to the taxpayer’s expected refund amount after deduction of all fees. Please check with your software provider for availability as some options may not be offered. All information is as of June 2024 and is subject to change.

2 The Netspend Visa Prepaid Card is issued by Republic Bank & Trust Company, Member FDIC pursuant to a license from Visa U.S.A. Inc. Ouro Global, Inc. is a registered agent of Republic Bank & Trust Company. This card may be used everywhere Visa debit cards are accepted. Card use is subject to activation, ID verification, and funds availability. Transaction fees, terms, and conditions apply to the use and reloading of the Card Account. See the Cardholder Agreement at www.republictaxpayer.com/terms for details.

3 If a customer chooses direct deposit, it may take additional time for their financial institution to post the funds to their account.
Signature*

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SMARTAXX CHRISTMAS LOAN ADVANCE FORM