Cash Advance Waitlist Form
Form to collect information for individuals interested in joining the waitlist for cash advances.
Full Name
*
First Name
Last Name
Phone Number
*
City
*
Email Address
*
example@example.com
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Desired Tax Advance Amount
*
Advances Up to $7,000 depending on tax refund amount
Will you have all of your tax documents by Jan 2?
*
Do you plan to file taxes with us?
*
Yes
No
I acknowledge that the tax advance is based on filing my taxes, and I understand that once the advance is submitted, my tax return will be e-filed to the IRS upon acknowledgment.
*
I acknowledge this
Submit
Should be Empty: