Applicant: ALTON CHESSON
Loan ID: 500FastCash-1942040008
Application
Date : 06/06/2011 src: 500fastcash.com 36288

Personal Information
Applicant Name: ALTON CHESSON
Applicants Address:
4027 SANDHILL CRANE TERRACE
Middleburg FL 32068
DOB: 08-12-1954

SS#: ***-**-2280

Home Phone #: (912) 306-0098
Length at address:
Unspecified
Fax Number: N/A
E-Mail address: ALTONCHESSON@ATT.NET
Cell Number: (912) 306-0098
Drivers License: C250-000-54-292-0
Employment / Income Information
Employer: SOCIAL SECURITY ADMINISTRATION
Income comes from? employment
Your work phone: (886) 964-7350

Length of Employment: 3 months
Monthly Take Home pay*: $3,350.00
Position:
Net pay each pay check*: $1,546.00
Shift/Hours:
Next four pay dates: 2011-06-10 & 2011-06-24 & 2011-07-08 & 2011-07-22
Direct Deposit?: TRUE
Paid how often: bi_weekly
Checking Account Information
BANK NAME: Navy FCU
ABA/ROUTING: 256074974
ACCOUNT NUMBER: ********4950
NEXT CHECK NUMBER:
Personal References
Ref #1 name: Daniel Bradshaw
Ref #2 name: Afredia Turner
Ref #1 phone: (757) 406-2047
Ref #2 phone: (757) 482-5622
Ref #1 relationship: EXTENDED_FAMILY
Ref #2 relationship: SIBLING

*or other source of income periodically deposited to your account. However, alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.
NOTICE: We adhere to the Patriot Act and we are required by law to adopt procedures to request and retain in our records information necessary to verify your identity. Agreement to Arbitrate All Disputes: By signing below or electronically signing and to induce us, 500FastCash, to process your application for a loan, you and we agree that any and all claims, disputes or controversies that we or our servicers or agents have against you or that you have against us, our servicers, agents, directors, officers and employees, that arise out of your application for one or more loans, the Loan Agreements that govern your repayment obligations, the loan for which you are applying or any other loan we previously made or later make to you, this Agreement To Arbitrate All Disputes, collection of the loan or loans, or alleging fraud or misrepresentation, whether under the common law or pursuant to federal or state statute or regulation, or otherwise, including disputes as to the matters subject to arbitration, shall be resolved by binding individual (and not class) arbitration by and under the Code of Procedure of the National Arbitration Forum ("NAF") in effect at the time the claim is filed. This agreement to arbitrate all disputes shall apply no matter by whom or against whom the claim is filed. Rules and forms of the NAF may be obtained and all claims shall be filed at any NAF office, on the World Wide Web at www.arb-forum.com, or at "National Arbitration Forum, P.O. Box 50191, Minneapolis, Minnesota 55405." If you are unable to pay the costs of arbitration, your arbitration fees may be waived by the NAF. The cost of a participatory hearing, if one is held at your or our request, will be paid for solely by us if the amount of the claim is $15,000 or less. Unless otherwise ordered by the arbitrator, you and we agree to equally share the costs of a participatory hearing of the claim is for more than $15,000 or less than $75,000. Any participatory hearing will take place at a location near your residence. This arbitration agreement is made pursuant to a transaction involving interstate commerce. It shall be governed by the Federal Arbitration Act, 9 U.S.C. Sections 1-16. Judgment upon the award may be entered by any party in any court having jurisdiction. This Agreement to Arbitrate All Disputes is an independent agreement and shall survive the closing, funding, repayment and/or default of the loan for which you are applying.
NOTICE: YOU AND WE WOULD HAVE HAD A RIGHT OR OPPORTUNITY TO LITIGATE DISPUTES THROUGH A COURT AND HAVE A JUDGE OR JURY DECIDE THE