Dealing with PDL companies

Loan Shop Online Extension Form --- XpressCash/DMS Marketing

Please SIGN and FAX to 1-800-757-8373 or REPLY TO THIS EMAIL at least 4 business days before your due date


Pamela Blundell
2026 E 50th St N
Tulsa, OK 74130

Loan ID: 192784
Current Due Date: 6/1/2007

Please check one of the options below:

______ I only want to pay my extension fee.

______ I want to clear any balance.

______ I want to pay my extension fee plus a paydown of $_________.

*** ______ Continue to paydown by this amount until my balance is cleared.


Your payment will be presented for payment electronically.

THE FOLLOWING MUST BE FILLED IN COMPLETELY:


DAYTIME TELEPHONE NUMBER: ________________________________


SOCIAL SECURITY #: ________________________________

All extension requests are subject to Processing Center approval. This entire agreement is constructed under and in accordance with the laws of Delaware.

You authorize the Processing Center to initiate Debit/Credit entries to your account on file for all payments due, including any unpaid returned item fees due, on which this agreement is drawn and the financial institution at which the account is held. This authority is to remain in full force and effect until the Processing Center has been paid in full. At our option, should we not receive your Extension Form prior to your four-day notice period, based on your past extension history, we will extend your loan in lieu of debiting your account for the full amount due.

Agreement not to bring or participate in Class Actions: To the extent permitted by Law, you agree that you will not bring, join, or participate in any class actions as to any claim, dispute, or controversy you may have against us or the company, you agree to the entry of injunctive relief to stop such lawsuit or to remove you as a particpant in the suit. This agreement does not constitute a waiver of any of your rights and remedies to pursue a claim individually and not as a class action in binding arbitration as provided in the application which was signed and construed on the transaction date.

You agree to binding arbitration which was stated in the original documents and by law is governed by your signature.

PLEASE SIGN AND FAX TO 1-800-757-8373
or REPLY TO THIS EMAIL ADDRESS
AT LEAST 4 BUSINESS DAYS BEFORE YOUR DUE DATE

To reach a customer service representative for any reason,
please call 1-800-757-0122 or email customerservice(at)ltsmanagement.com


CUSTOMER SIGNATURE ____________________________ DATE____________