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 Highland Quick Cash, Inc. (Lender).   
Highland Quick Cash, 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
Highland Quick Cash, 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
Highland Quick
Cash, Inc. to the extent not prohibited by law.  I understand that
Highland Quick Cash, 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
Highland Quick Cash, Inc.
Highland Quick Cash, Inc. 12589 State Rt. 143 Highland, IL 62249 Ph 618-651-1600

INSTALLMENT PAYDAY LOAN APPLICATION
Highland Quick Cash