QUICK CASH LOANS
UP TO $5,000!

In this Advance Application (herein referred to as the "Application"), the words "you" and "your" mean the Applicant identified below. The word "we", "our", "us", mean "Blieknight Financial LLC.

Optional

Are you planning to file for Bankruptcy within 12 months?

Income Information*

$

Direct Deposit

Paid by

*Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considerd as a basis for repaying this obligation.

Additional Income Information*

Direct Deposit

Paid by

*Alimony, child support or separate maintenance income need not be revealed if you do not wish to have it considerd as a basis for repaying this obligation.

Bank Information

Personal References

How Did You Hear About Blueknight Financial LLC

Arbitration

Arbitration is a means for legal matters between parties to be resolved by a neutral arbitrator rather than a Court. Blueknight Financial LLC has a policy of arbitrating all claims, demands, and disputes which cannot be resolved in a small claims tribunal, including the scope and validity of this arbitration provision and any right you may have to participate in an alleged class action (hereinafter 4dispute(s)”). All customer agreements contain another arbitration provision that supersedes this arbitration provision and governs the resolution of disputes. However. if you do not enter into a customer agreement with us, then this arbitration provision governs the resolution of disputes. You agree that YOU ARE WAIVING YOUR RIGHT TO HAVE A TRIAL BY JURY to resolve disputes against us, our agents and/or owners. The Federal Arbitration Act governs this arbitration provision. If either party has a dispute, they must notify the other in minting of the dispute. You have the right to select either of the following arbitration Organizations, which will govern the arbitration under its consumer rules: American Arbitration Association (1-800-778-7879) http://www.adr.org, or J.A.M.S./Endispute (1-800-625-5267) http:/Avww.jamsadr.com, and we will advance all of the expenses associated with the arbitration, including the filing, administrative, hearing and arbitrator’s fees. You will be responsible for your attorney’s fees, if any. Any appeal of a judgment from a small claims tribunal shall be resolved by binding arbitration. The arbitrator shall not conduct class arbitration. The arbitration hearing will be conducted in the county in which this Application was signed.

Read Before Signing

You agree that you have read and understood all the above statements, including the Arbitration Provision.

You certify the information supplied by you on this form is true and correct You authorize verification of the truthfulness of all information contained herein, including contact with any person or firm fisted above, and fully release all parties from all liability for any damage that may result. Any false statement made above shall be sufficient basis for rejection. You certify that you have mad and understand the above statement.

You certify that you have received, reviewed and understand Blueknight Financial LLC’s Privacy Policy and Notice.

**You authorize us to call you at any number you provide or at any number at which we reasonably believe we can contact you. including calls to mobile, cellular, or similar devices for any lawful purpose including our use of an automatic dialing telephone system or prerecorded voice. You also agree to any fee(s) or charge(s) that you may incur for incoming calls from us, and/or outgoing calls to us, to or from any such number, without reimbursement from us. WE MAY REPORT INFORMATION ABOUT YOUR ACCOUNT TO CREDIT BUREAUS. LATE PAYMENTS, MISSED PAYMENTS, OR OTHER DEFAULTS ON YOUR ACCOUNT MAY BE REFLECTED IN YOUR CREDIT REPORT.

Important Customer Contact Consent

You hereby consent to receive information regarding the status of your account, special offers and promotions on behalf of BlueKnight LLC at the telephone numbers(s) provided on page 1 of this document via autodialed and/or pre-recorded telemarketing call and texts messages. You also agree to any fee(s) you may incur from incoming calls or text messages from us. and/or outgoing calls or text message to us. to or from any such number, without reimbursement from us. You understand that consent is not a condition of loan approval. You may revoke this consent at any time by writing us at: Blueknight Financial LLC, 6900 N Dallas Parkway Ste # 375, Plano TX 75024. If you wish to opt out of receiving emails from Blueknight Financial, please send us an email.